0001354488-16-008572.txt : 20161121 0001354488-16-008572.hdr.sgml : 20161121 20161121150602 ACCESSION NUMBER: 0001354488-16-008572 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161116 FILED AS OF DATE: 20161121 DATE AS OF CHANGE: 20161121 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FUSION TELECOMMUNICATIONS INTERNATIONAL INC CENTRAL INDEX KEY: 0001071411 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 582342021 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 1718 CITY: NEW YORK STATE: NY ZIP: 10170 BUSINESS PHONE: (212) 201-2400 MAIL ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 1718 CITY: NEW YORK STATE: NY ZIP: 10170 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BLUM LAWRENCE H CENTRAL INDEX KEY: 0000939616 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32421 FILM NUMBER: 162010144 MAIL ADDRESS: STREET 1: C/O BANKUNITED FINANCIAL CORP STREET 2: 255 ALHAMBRA CIRCLE CITY: CORAL GABLES STATE: FL ZIP: 33134 4 1 issuerdirect_section16.xml PRIMARY DOCUMENT X0306 4 2016-11-16 0 0001071411 FUSION TELECOMMUNICATIONS INTERNATIONAL INC FSNN 0000939616 BLUM LAWRENCE H 420 LEXINGTON AVENUE, SUITE 1718 NEW YORK NY 10170 1 Common stock, par value $0.01 per share 2016-11-16 4 P 0 13044 1.15 A 40806 I By Trust Options 1.21 2016-11-16 4 P 0 10000 0 A 2017-11-11 2026-11-11 Common Stock 10000 32750 D Owned by the Francine M. Blum Revocable Trust. Options vest on a pro-rata basis over 3 years. Includes 6,600 shares of Series B-2 Preferred Stock and 10,000 warrants. /s/ Lawrence Blum 2016-11-21