-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Hq7IO/QFk+PZKLBIIHe9i6QXkQq68uNRCBcKCyo9EKcOVcudrWC2CJp42c5PShi6 B09l90tClUJ0rqJ3HKRc2w== 0001144204-07-048770.txt : 20070910 0001144204-07-048770.hdr.sgml : 20070910 20070910194934 ACCESSION NUMBER: 0001144204-07-048770 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070907 FILED AS OF DATE: 20070910 DATE AS OF CHANGE: 20070910 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Green Ann C W CENTRAL INDEX KEY: 0001411838 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21609 FILM NUMBER: 071109855 BUSINESS ADDRESS: BUSINESS PHONE: (732) 741-1500 MAIL ADDRESS: STREET 1: 636 RIVER ROAD CITY: FAIR HAVEN STATE: NJ ZIP: 07704 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: TX FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: POB 6199 STREET 2: 636 RIVER ROAD CITY: FAIRHAVEN STATE: NJ ZIP: 07704 BUSINESS PHONE: 732-741-1925 MAIL ADDRESS: STREET 1: POB 6199 STREET 2: 636 RIVER ROAD CITY: FAIRHAVEN STATE: NJ ZIP: 07704 4 1 v087404_ex.xml X0202 4 2007-09-07 0 0001025771 CHASE PACKAGING CORP CPKA 0001411838 Green Ann C W 636 RIVER ROAD FAIR HAVEN NJ 07704 0 1 0 0 CFO & Assistant Secretary Common Stock 2007-09-07 4 P 0 112500 A 301275 D Series A 10% Convertible Preferred Stock 0.10 2007-09-07 4 P 0 225 A Common 225000 225000 D Warrants 0.15 2007-09-07 4 P 0 112500 A 2012-09-07 Common 112500 112500 D Reporting person's IRA purchased 225 investment units in Company's private placement transaction at a per unit purchase price of $150. Each investment unit consists of one share of Series A 10% Convertible Preferred Stock, par value $1.00 per share, stated value $100 per share convertible into common shares at $0.10 per share; 500 shares of the Company's $0.10 par value Common Stock; and 500 Warrants. 143,970 common shares held in reporting person's IRA. Currently exercisable. Not applicable. /s/ Ann C W Green 2007-09-10 -----END PRIVACY-ENHANCED MESSAGE-----