0001179110-12-002549.txt : 20120214 0001179110-12-002549.hdr.sgml : 20120214 20120214170730 ACCESSION NUMBER: 0001179110-12-002549 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111231 FILED AS OF DATE: 20120214 DATE AS OF CHANGE: 20120214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MCINNES ALLEN T CENTRAL INDEX KEY: 0001182279 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21609 FILM NUMBER: 12612347 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 - X0304 5 2011-12-31 0 0 0 0001025771 CHASE PACKAGING CORP CPKA 0001182279 MCINNES ALLEN T 4532 7TH STREET LUBBOCK TX 79416 1 1 1 0 COB, President and Treasurer Series A 10% Convertible Preferred Stock 0.10 Common Stock 2295000 2295000 D Currently exercisable. Not applicable. Adjusted to reflect the annual 10% stock dividends paid by the Company to all holders of Series A 10% Convertible Preferred Stock on December 1, 2010 and December 1, 2011. Allen T. McInnes 2012-02-14