03/28/2024 | Press release | Distributed by Public on 03/28/2024 19:22
FORM 4
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Title of Derivate Security | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security | 8. Price of Derivative Security | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) | 11. Nature of Indirect Beneficial Ownership |
Code | V | (A) | (D) | Date Exercisable | Expriation Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Impact Prosperity Partners, LLC 424 FORT HILL DRIVE, SUITE 144 NAPERVILLE, IL60540 |
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Former 10% Owner |
Impact Services, LLC 424 FORT HILL DRIVE, SUITE 144 NAPERVILLE, IL60540 |
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Former 10% Owner |
ADS Manager, LLC 424 FORT HILL DRIVE, SUITE 144 NAPERVILLE, IL60540 |
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Former 10% Owner |
Simpson Anna 424 FORT HILL DRIVE, SUITE 144 NAPERVILLE, IL60540 |
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Former 10% Owner |
/s/ Rajesh Gupta, as an authorized signatory of IPP and IPS | 2024-03-28 |
**Signature of Reporting Person | Date |
/s/ Anna Simpson, for herself and as an authorized signatory of ADS | 2024-03-28 |
**Signature of Reporting Person | Date |
(*) | If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
(**) | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | These securities were beneficially owned directly by Impact Prosperity Partners, LLC ("IPP"), for the benefit of certain holders of rights as lenders under certain secured notes (the "Lenders") (IPP, in such capacity, the "Record Owner"). Impact Services, LLC ("IPS") and ADS Manager, LLC ("ADS") are the managing members of IPP. Mr. Rajesh Gupta is the manager and a member of IPS. Ms. Simpson is the sole member of ADS. Immediately after acquisition of these securities on December 29, 2023, the Record Owner transferred record ownership of these securities to its affiliate Omni Retail Enterprises LLC, for the benefit of the Lenders. There was no change in the pecuniary interests in these securities as a result of such transfer. |
(2) | Each Reporting Person disclaims beneficial ownership of all securities reported herein, except to the extent of their pecuniary interest therein, if any, and this report shall not be deemed an admission that such Reporting Person is the beneficial owner of such securities for purposes of Section 16 of the Securities and Exchange Act of 1934 or for any other purpose. |