Statement of Changes in Beneficial Ownership (4)
26 Janvier 2017 - 6:23PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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. Name and Address of Reporting Person
*
PERKINS ALTON
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2. Issuer Name
and
Ticker or Trading Symbol
ATI Modular Technology Corp.
[
GREI
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Chair - CEO - CFO
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(Last)
(First)
(Middle)
4700 HOMEWOOD COURT, SUITE 100
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3. Date of Earliest Transaction
(MM/DD/YYYY)
7/1/2016
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(Street)
RALEIGH, NC 27609
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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7/1/2016
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A
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10000000
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A
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$.001
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100117323
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I
(1)
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Via controlling interest in the Alton & Xiang Mei Lin Perkins Family Trust (the "Perkins Trust")
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Common Stock
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(2)
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7/1/2016
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A
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5000000
(2)
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7/1/2017
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7/1/2022
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Common Stock
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5000000
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(2)
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100117323
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D
(2)
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Explanation of Responses:
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(
1)
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For information regarding the nature of all of Mr. Perkins holdings under Issuer ATI Modular Technology Corp., please see his Form 3 previously filed on Edgar on October 21, 2016.
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(
2)
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The Reporting Person, or his authorized designee, has an option to purchase up to 5,000,000 shares of common stock of the Issuer per year at any time prior to the conclusion of the first year of the Agreement, i.e. prior to 365 days after execution of the Reporting Person's Employment Agreement, at a price of 1.5% per share of the closing price of the Company's stock quoted on a major exchange or over-the-counter marketplace one business day before purchase, and annually thereafter for a total of 5 consecutive years. The shares purchased under the option are subject to all rights and restrictions set forth in the Schedule to the Employment Agreement.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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PERKINS ALTON
4700 HOMEWOOD COURT
SUITE 100
RALEIGH, NC 27609
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X
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X
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Chair - CEO - CFO
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Signatures
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Leisanne Smeadala, Limited Power of Attorney for Alton Perkins
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1/26/2017
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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