0001179110-15-002652.txt : 20150219
0001179110-15-002652.hdr.sgml : 20150216
20150217175117
ACCESSION NUMBER: 0001179110-15-002652
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20141231
FILED AS OF DATE: 20150217
DATE AS OF CHANGE: 20150217
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CHASE PACKAGING CORP
CENTRAL INDEX KEY: 0001025771
STANDARD INDUSTRIAL CLASSIFICATION: AGRICULTURE SERVICES [0700]
IRS NUMBER: 931216127
STATE OF INCORPORATION: NJ
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 636 RIVER ROAD
CITY: FAIRHAVEN
STATE: NJ
ZIP: 07704
BUSINESS PHONE: 732-741-1500
MAIL ADDRESS:
STREET 1: POB 6199
STREET 2: 636 RIVER ROAD
CITY: FAIRHAVEN
STATE: NJ
ZIP: 07704
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GARDNER HERBERT M
CENTRAL INDEX KEY: 0000923414
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-21609
FILM NUMBER: 15624770
MAIL ADDRESS:
STREET 1: P O BOX 6199
CITY: FAIR HAVEN
STATE: NJ
ZIP: 07704
5
1
edgar.xml
FORM 5 -
X0306
5
2014-12-31
0
0
0
0001025771
CHASE PACKAGING CORP
CPKA
0000923414
GARDNER HERBERT M
P. O. BOX 463
WADING RIVER
NY
11792
1
1
1
0
Vice President
Common Stock
927297
D
Common Stock
167590
I
By GST U/W/O Mary Gardner
Series A 10% Convertible Preferred Stock
.10
Common Stock
1970000
1970000
D
Series A 10% Convertible Preferred Stock
.10
Common Stock
349000
349000
I
By GST U/W/O Mary K. Gardner
Warrants
.15
2015-09-07
Common Stock
623500
623500
D
Warrants
.15
2015-09-07
Common Stock
89000
89000
I
By GST U/W/O Mary K. Gardner
Incentive Stock Option
0.03
2018-06-24
CommonStock
50000
50000
D
Reporting person disclaims beneficial ownership of shares and warrants owned by the Generation Skipping Marital Trust U/W/O Mary K. Gardner, of which the reporting person is a Co-Trustee.
1,058 shares of Series A Convertible Preferred Stock (convertible into 1,058,000 Common shares) are held in IRA Rollover.
Adjusted to reflect the annual 10% stock dividends paid by the Company to all holders of Series A Convertible Preferred Stock on December 1, 2013 and December 1, 2014.
Currently exercisable.
Not applicable.
/s/ Julia A. Gardner, Attorney-in-Fact for Herbert M. Gardner
2015-02-17