0000950142-16-004204.txt : 20160729 0000950142-16-004204.hdr.sgml : 20160729 20160729171839 ACCESSION NUMBER: 0000950142-16-004204 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160630 FILED AS OF DATE: 20160729 DATE AS OF CHANGE: 20160729 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SG BLOCKS, INC. CENTRAL INDEX KEY: 0001023994 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-LUMBER & OTHER CONSTRUCTION MATERIALS [5030] IRS NUMBER: 954463937 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3 COLUMBUS CIRCLE STREET 2: 16TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 BUSINESS PHONE: (212) 520-6218 MAIL ADDRESS: STREET 1: 3 COLUMBUS CIRCLE STREET 2: 16TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 FORMER COMPANY: FORMER CONFORMED NAME: CDSI HOLDINGS INC DATE OF NAME CHANGE: 19990114 FORMER COMPANY: FORMER CONFORMED NAME: PC411 INC DATE OF NAME CHANGE: 19961001 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Grossman Bruce CENTRAL INDEX KEY: 0001638139 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-22563 FILM NUMBER: 161794964 MAIL ADDRESS: STREET 1: C/O DILLON HILL CAPITAL LLC STREET 2: 200 BUSINESS PARK DRIVE, SUITE 306 CITY: ARMONK STATE: NY ZIP: 10504 3 1 es1600846_3-grossman.xml OWNERSHIP DOCUMENT X0206 3 2016-06-30 0 0001023994 SG BLOCKS, INC. SGBX 0001638139 Grossman Bruce C/O DILLON HILL CAPITAL LLC 200 BUSINESS PARK DRIVE, SUITE 306 ARMONK NY 10504 0 0 1 0 Series A Convertible Preferred Stock 1 Common Stock 1111500 I See Footnote The Series A Convertible Preferred Stock became convertible on June 30, 2016 and has a perpetual duration. Dillon Hill Capital, LLC, of which the Reporting Person is the sole member, directly owns 741,000 shares of Series A Convertible Preferred Stock. Dillon Hill Investment Company, LLC, the sole member of which is a trust of which the Reporting Person's spouse is a co-trustee, directly owns 370,500 shares of Series A Convertible Preferred Stock. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. /s/ Bruce Grossman 2016-07-29