Amended Statement of Beneficial Ownership (sc 13d/a)
17 Mars 2020 - 9:06PM
Edgar (US Regulatory)
UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
SCHEDULE
13D
Under
the Securities Exchange Act of 1934
(Amendment
No. 1)*
Intellinetics,
Inc.
(Name
of Issuer)
(Title
of Class of Securities)
(CUSIP
Number)
Michael
Taglich, 790 New York Ave., Huntington, NY 11743
(Name,
Address and Telephone Number of Person
Authorized
to Receive Notices and Communications)
(Date
of Event which Requires Filing of this Statement)
If
the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule
13D, and is filing this schedule because of §§240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box. [ ]
Note:
Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See §240.13d-7
for other parties to whom copies are to be sent.
*
The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect
to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided
in a prior cover page.
The
information required on the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section
18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the Notes).
CUSIP No. 45825X105
|
13D
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Page 2 of 4 Pages
|
1.
|
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NAMES
OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
Michael
Taglich
|
2.
|
|
CHECK
THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(see
instructions)
(a)
[ ]
(b)
[ ]
|
3.
|
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SEC
USE ONLY
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4.
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SOURCE
OF FUNDS (see instructions)
PF
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5.
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CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) [ ]
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6.
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CITIZENSHIP
OR PLACE OF ORGANIZATION
USA
|
NUMBER
OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
|
|
7.
|
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SOLE
VOTING POWER
23,128,399
|
|
8.
|
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SHARED
VOTING POWER
00,000
|
|
9.
|
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SOLE
DISPOSITIVE POWER
23,128,399
|
|
10.
|
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SHARED
DISPOSITIVE POWER
00,000
|
11.
|
|
AGGREGATE
AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
23,128,399
|
12.
|
|
CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
(see
instructions) [ ]
|
13.
|
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PERCENT
OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
16%
|
14.
|
|
TYPE
OF REPORTING PERSON (see instructions)
IN
|
CUSIP No. 45825X105
|
13D
|
Page 3 of 4 Pages
|
This
amendment (“Amendment No. 3”), amends the Schedule 13D originally filed with the SEC on April 29, 2015 (the
“Schedule”), to report securities sold and associated change in the percentage of the Issuer’s common
stock owned by the Reporting Person.
Item
5. Interest in Securities of the Issuer.
Item
5 of the Schedule is amended and replaced in its entirety as follows:
|
(a)
|
Michael
Taglich beneficially owns 23,128,399 shares of common stock of Intellinetics, Inc., representing 16% of the common stock of
Intellinetics. Inc.
|
|
|
|
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(b)
|
Michael
Taglich has both voting power and dispositive power over such common stock.
|
|
|
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(c)
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During
the past 60 days, Michael Taglich has effected the following transactions in the Issuer’s
Common Stock:
|
On
March 2, 2020, 11,247,635 shares of common stock were acquired through the conversion of all outstanding principal and accrued
interest from convertible promissory notes with an aggregate original principal balance of $725,000, at a conversion price of
$0.08 per share. This transaction was settled directly with the Issuer.
On
March 2, 2020, 7,437,500 shares of common stock were acquired at a purchase price of $0.08 per share. This transaction was settled
with the Issuer directly in cash.
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(d)
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None.
|
|
|
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(e)
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Not
applicable
|
Item
6. Contracts, Arrangements, Understandings or Relationships with Respect to Securities of the Issuer.
None.
Item
7. Material to Be Filed as Exhibits.
None.
CUSIP No. 45825X105
|
13D
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Page 4 of 4 Pages
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SIGNATURE
After
reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true,
complete and correct.
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Michael
Taglich
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/s/
Michael Taglich
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(USOTC:INLX)
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