0001179110-16-019360.txt : 20160216
0001179110-16-019360.hdr.sgml : 20160215
20160216193929
ACCESSION NUMBER: 0001179110-16-019360
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20151231
FILED AS OF DATE: 20160216
DATE AS OF CHANGE: 20160216
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: BARRETT WILLIAM J
CENTRAL INDEX KEY: 0000923415
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-21609
FILM NUMBER: 161431148
MAIL ADDRESS:
STREET 1: P O BOX 6199
CITY: FAIR HAVEN
STATE: NJ
ZIP: 07704
5
1
edgar.xml
FORM 5 -
X0306
5
2015-12-31
0
0
0
0001025771
CHASE PACKAGING CORP
CPKA
0000923415
BARRETT WILLIAM J
P. O. BOX 6199
FAIR HAVEN
NJ
07704
1
1
1
0
Secretary
Common Stock
1288560
D
Common Stock
286345
I
By spouse
Series A 10% Convertible Preferred Stock
0.10
Common Stock
4000000
4000000
D
Series A 10% Convertible Preferred Stock
0.10
Common Stock
729000
729000
I
By Spouse
Warrants
0.15
2017-09-07
Common Stock
78500
78500
D
Warrants
0.15
2017-09-07
Common Stock
167000
167000
I
By spouse
Incentive Stock Option
0.03
2018-06-24
Common Stock
50000
50000
D
Reporting Person disclaims beneficial ownership of shares and warrants owned by spouse.
Currently exercisable.
Not applicable.
Adjusted to reflect the annual 10% stock dividend paid by the Company to all holders of Series A Convertible Preferred Stock on December 1, 2015.
/s/ Julia A. Gardner, Attorney-in-Fact for William J. Barrett
2016-02-16