0001179110-21-010275.txt : 20211119 0001179110-21-010275.hdr.sgml : 20211119 20211119161504 ACCESSION NUMBER: 0001179110-21-010275 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211117 FILED AS OF DATE: 20211119 DATE AS OF CHANGE: 20211119 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HARRIS DONALD A CENTRAL INDEX KEY: 0001134583 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33169 FILM NUMBER: 211428476 MAIL ADDRESS: STREET 1: C/O NFINANSE INC. STREET 2: 3923 COCONUT PALM DRIVE, SUITE 107 CITY: TAMPA STATE: FL ZIP: 33619 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CREATIVE REALITIES, INC. CENTRAL INDEX KEY: 0001356093 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 411967918 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 13100 MAGISTERIAL DRIVE STREET 2: SUITE 100 CITY: LOUISVILLE STATE: KY ZIP: 40223 BUSINESS PHONE: 502-791-8800 MAIL ADDRESS: STREET 1: 13100 MAGISTERIAL DRIVE STREET 2: SUITE 100 CITY: LOUISVILLE STATE: KY ZIP: 40223 FORMER COMPANY: FORMER CONFORMED NAME: WIRELESS RONIN TECHNOLOGIES INC DATE OF NAME CHANGE: 20060313 4 1 edgar.xml FORM 4 - X0306 4 2021-11-17 0 0001356093 CREATIVE REALITIES, INC. CREX 0001134583 HARRIS DONALD A C/O NFINANSE INC. 3923 COCONUT PALM DRIVE, STE 107 TAMPA FL 33619 1 0 0 0 Common Stock 2021-11-17 4 A 0 10860 0 A 190893 D Stock Options (right to buy) 2.21 2021-11-17 4 A 0 60000 0 A 2031-11-17 Common Stock 60000 60000 D Option vests as to 20,000 shares on each of 11/17/2021, 11/17/2022 and 11/17/2023. Exhibit 24.1 Power of Attorney filed with Form 4 on 04/17/2020 and incorporated herein by reference. /s/ Will Logan, as Attorney-in-fact for Donald A. Harris 2021-11-19