0001477932-19-001490.txt : 20190405
0001477932-19-001490.hdr.sgml : 20190405
20190405145915
ACCESSION NUMBER: 0001477932-19-001490
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181231
FILED AS OF DATE: 20190405
DATE AS OF CHANGE: 20190405
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: 19734840
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
form5.xml
FORM 5
X0306
5
2018-12-31-07:00
false
0
0
0001025771
CHASE PACKAGING CORP
CPKA
0001411838
Green Ann C W
312 RUTLEDGE DRIVE
RED BANK
NJ
07701
false
true
false
false
CFO & Asst. Sect.
Common Stock
2018-12-31-07:00
5
M
false
731766
A
1039041
D
Series A Convertible Preferred
0.085
2018-12-31-07:00
5
M
false
622
0
D
2018-12-31-07:00
2018-12-31-07:00
Common Stock
731766
0
D
Warrants
0.15
2019-09-07-06:00
Common Stock
118500
118500
D
Conversion Price: $0.085/share pursuant to a recapitalization.
Adjusted to reflect the annual 10% stock dividend paid by the Company to all holders of Series A Convertible Preferred Stock.
Currently exercisable.
/s/ Ann C W Green
2019-04-05-06:00