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