-----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, PSyD8yWIVMvd6Cmqz5BIYYnVFOd9mDAmnnoADSjZy2GKaxsZrSbd0v50JIWq6qb+ ugRYzA6Vwn5pIeAu62SsSA== 0001179110-10-002944.txt : 20100216 0001179110-10-002944.hdr.sgml : 20100215 20100216175945 ACCESSION NUMBER: 0001179110-10-002944 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091231 FILED AS OF DATE: 20100216 DATE AS OF CHANGE: 20100216 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Green Ann C W CENTRAL INDEX KEY: 0001411838 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21609 FILM NUMBER: 10610340 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: 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 5 1 edgar.xml FORM 5 - X0303 5 2009-12-31 0 0 0 0001025771 CHASE PACKAGING CORP CPKA 0001411838 Green Ann C W 636 RIVER ROAD FAIR HAVEN NJ 07704 0 1 0 0 CFO & Asst. Secy. Common Stock 307275 D Series A 10% Convertible Preferred Stock .10 Common 291000 291000 D Warrants .15 2012-09-07 Common 118500 118500 D Currently exercisable. Not applicable. Adjusted to reflect the annual 10% stock dividends paid by the Company to all holders of record of Series A 10% Convertible Preferred Stock on December 1, 2008 and December 1, 2009. Ann C.W. Green 2010-02-16 -----END PRIVACY-ENHANCED MESSAGE-----