0001415889-18-001646.txt : 20181115
0001415889-18-001646.hdr.sgml : 20181115
20181115151742
ACCESSION NUMBER: 0001415889-18-001646
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181113
FILED AS OF DATE: 20181115
DATE AS OF CHANGE: 20181115
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dawson Grant Robert
CENTRAL INDEX KEY: 0001465378
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-52369
FILM NUMBER: 181187103
MAIL ADDRESS:
STREET 1: C/O GLOWPOINT, INC.
STREET 2: 430 MOUNTAIN AVENUE, SUITE 301
CITY: MURRAY HILL
STATE: NJ
ZIP: 07974
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FITLIFE BRANDS, INC.
CENTRAL INDEX KEY: 0001374328
STANDARD INDUSTRIAL CLASSIFICATION: MEDICINAL CHEMICALS & BOTANICAL PRODUCTS [2833]
IRS NUMBER: 000000000
STATE OF INCORPORATION: NV
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 5214 S. 136TH STREET
CITY: OMAHA
STATE: NE
ZIP: 68137
BUSINESS PHONE: 402-884-1894
MAIL ADDRESS:
STREET 1: 5214 S. 136TH STREET
CITY: OMAHA
STATE: NE
ZIP: 68137
FORMER COMPANY:
FORMER CONFORMED NAME: BOND LABORATORIES, INC.
DATE OF NAME CHANGE: 20060831
4
1
form4-11152018_121127.xml
X0306
4
2018-11-13
0001374328
FITLIFE BRANDS, INC.
FTLF
0001465378
Dawson Grant Robert
C/O FITLIFE BRANDS, INC.
5214 S. 136TH STREET
OMAHA
NE
68137
true
false
false
false
Series A Preferred
0.46
2018-11-13
4
P
0
25
A
2018-11-13
Common Stock
54348
25
D
Warrant
0.46
2018-11-13
4
P
0
16304
A
2018-11-13
2023-11-13
Common Stock
16304
16304
D
Shares of the Issuer's Series A Preferred do not expire.
The Reporting Person purchased 25 units ("Units") for $1,000 per Unit, with each Unit consisting of one share of the Issuer's Series A Preferred Stock, par value $0.01 per share, and a five-year warrant to purchase that number of shares of the Issuer's common stock equal to 30% of the shares of the Issuer's common stock issuable upon conversion of the Series A Preferred purchased by the Reporting Person.
/s/ Grant R. Dawson
2018-11-15