0001179110-21-003022.txt : 20210308
0001179110-21-003022.hdr.sgml : 20210308
20210308110930
ACCESSION NUMBER: 0001179110-21-003022
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210130
FILED AS OF DATE: 20210308
DATE AS OF CHANGE: 20210308
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Simpson Tom
CENTRAL INDEX KEY: 0001808347
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-14818
FILM NUMBER: 21721009
MAIL ADDRESS:
STREET 1: 38 CORPORATE CIRCLE
CITY: ALBANY
STATE: NY
ZIP: 12203
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Kaspien Holdings Inc.
CENTRAL INDEX KEY: 0000795212
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL- COMPUTER & PRERECORDED TAPE STORES [5735]
IRS NUMBER: 141541629
STATE OF INCORPORATION: NY
FISCAL YEAR END: 0201
BUSINESS ADDRESS:
STREET 1: 2818 N. SULLIVAN RD.
CITY: SPOKANE
STATE: WA
ZIP: 99216
BUSINESS PHONE: 5184521242
MAIL ADDRESS:
STREET 1: 2818 N. SULLIVAN RD.
CITY: SPOKANE
STATE: WA
ZIP: 99216
FORMER COMPANY:
FORMER CONFORMED NAME: TRANS WORLD ENTERTAINMENT CORP
DATE OF NAME CHANGE: 19941212
FORMER COMPANY:
FORMER CONFORMED NAME: TRANS WORLD MUSIC CORP
DATE OF NAME CHANGE: 19920703
5
1
edgar.xml
FORM 5 -
X0306
5
2021-01-30
0
0
1
0000795212
Kaspien Holdings Inc.
KSPN
0001808347
Simpson Tom
2818 N. SULLIVAN ROAD
SPOKANE
WA
99216
1
0
0
0
Common stock, par value $0.1 per share
2020-11-25
4
X
0
12593
0.01
A
12593
I
By Kick Start III, LLC
Common stock, par value $0.1 per share
2020-11-25
4
X
0
8395
0.01
A
8395
I
By Kick Start IV, LLC
Common Stock, par value $.01 per share
57000
D
Common stock, par value $.01 per share
23879
I
By WIN Partners
Common Stock, par value $.01 per share
9737
I
By Kick Start, LLC
Common stock, par value $.01 per share
25
I
By Wife
Warrant to purchase Common Stock, par value $0.01 per share
.01
2020-11-25
4
X
0
12593
0
D
2020-03-30
2025-03-30
Common Stock, par value $0.01 per share
12593
1448
I
By Kick Start III, LLC
Warrant to purchase Common Stock, par value $0.01 per share
.01
2020-11-25
4
X
0
8395
0
D
2020-03-30
2025-03-30
Common Stock, par value $0.01 per share
8395
965
I
By Kick Start IV,LLC
Securities held by Kick Start, LLC. Mr. Simpson holds an interest, manages and has voting control of Kick Start, LLC.
Securities held by Kick Start III, LLC. Mr. Simpson holds an interest, manages and has voting control of Kick Start III.
Securities held by Kick Start IV, LLC. Mr. Simpson holds an interest, manages and has voting control of Kick Start IV, LLC.
Securities held by WIN Partners. Mr. Simpson holds an interest, manages and has voting control of WIN Partners.
Tom Simpson
2021-03-08