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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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
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 (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
See footnote (1) | $ 3.05 | 02/24/2009 | D(2) | $ 500,000 | 11/14/2010 | 11/14/2010 | Common Stock | 163,934 | (2) | $ 250,000 | I | See footnote (3) | |||
See footnote (1) | $ 3.05 | 02/24/2009 | D(2) | $ 250,000 | 11/14/2010 | 11/14/2010 | Common Stock | 81,967 | (2) | $ 0 | I | See footnote (3) | |||
See footnote (1) | $ 2.28 (4) | 02/24/2009 | A(2) | $ 500,000 | 11/14/2010 | 11/14/2010 | Common Stock | 219,298 | (2) | $ 500,000 | I | See footnote (3) | |||
See footnote (1) | $ 2.28 (4) | 02/24/2009 | A(2) | $ 250,000 | 11/14/2010 | 11/14/2010 | Common Stock | 109,649 | (2) | $ 750,000 | I | See footnote (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Roethler Doron C/O STRAUSS, ADAR, RAVIV & CO.LAW OFFICE 7 MENACHEM BEGIN, BETZALEL STREET RAMAT GAN, L3 52521 |
X | X | Interim CEO |
/s/ Margaret Cate, attorney-in-fact | 02/26/2009 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(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) | Convertible secured subordinated note due November 14, 2010 (collectively, the "Notes"). |
(2) | The reported transactions involved an amendment of outstanding Notes, resulting in the deemed cancellation of the "old" Notes and the deemed purchase of "replacement" Notes. |
(3) | Held by Crystal Management, Ltd., which is 100% owned by Doron Roethler. |
(4) | The Notes are convertible into Smart Online, Inc. (the "Issuer") common stock at the lowest "applicable conversion price" determined for each Note (issued to any noteholder), which shall be calculated by multiplying 120% by the lowest of (a) the average of the high and low prices of the Issuer's common stock on the OTCBB averaged over the 5 trading days prior to the closing date of the Note's issuance, (b) if the Issuer's common stock is not traded on the Over-The-Counter market, the closing price of the common stock reported on the principal exchange on which the common stock is listed, averaged over the 5 trading days prior to the closing date of the Note's issuance, or (c) the closing price of the Issuer's common stock on the OTCBB or the principal exchange on which the common stock is listed, as applicable, on the trading day preceding the date such Note is converted, in each case as adjusted for stock splits, dividends or combinations, recapitalizations or similar events. |