0001179110-17-001157.txt : 20170123 0001179110-17-001157.hdr.sgml : 20170123 20170123142031 ACCESSION NUMBER: 0001179110-17-001157 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150218 FILED AS OF DATE: 20170123 DATE AS OF CHANGE: 20170123 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CREATIVE REALITIES, INC. CENTRAL INDEX KEY: 0001356093 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 411967918 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 13100 MAGISTERIAL DRIVE STREET 2: SUITE 100 CITY: LOUISVILLE STATE: KY ZIP: 40223 BUSINESS PHONE: 502-791-8800 MAIL ADDRESS: STREET 1: 13100 MAGISTERIAL DRIVE STREET 2: SUITE 100 CITY: LOUISVILLE STATE: KY ZIP: 40223 FORMER COMPANY: FORMER CONFORMED NAME: WIRELESS RONIN TECHNOLOGIES INC DATE OF NAME CHANGE: 20060313 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HARRIS DONALD A CENTRAL INDEX KEY: 0001134583 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33169 FILM NUMBER: 17540780 MAIL ADDRESS: STREET 1: C/O NFINANSE INC. STREET 2: 3923 COCONUT PALM DRIVE, SUITE 107 CITY: TAMPA STATE: FL ZIP: 33619 4 1 edgar.xml FORM 4 - X0306 4 2015-02-18 0 0001356093 CREATIVE REALITIES, INC. CREX 0001134583 HARRIS DONALD A C/O NFINANSE INC. 3923 COCONUT PALM DRIVE, STE 107 TAMPA FL 33619 1 0 0 0 Common Stock 1715815 D Series A Convertible Preferred Stock 0.255 2015-02-18 4 P 0 50000 1.00 A 2015-02-18 Common Stock 196078 50000 D Warrants to purchase Common Stock 0.50 2015-02-18 4 P 0 62500 A 2015-02-18 2020-02-18 Common Stock 62500 62500 D Series A Convertible Preferred Stock 0.255 2015-06-30 4 J 0 1100 A 2015-06-30 Common Stock 4314 51100 D Series A Convertible Preferred Stock 0.255 2015-12-31 4 J 0 1533 A 2015-12-31 Common Stock 6012 52633 D Warrants to purchase Common Stock 0.28 2016-06-13 4 J 0 357143 A 2016-06-13 2021-06-13 Common Stock 357143 357143 D Series A Convertible Preferred Stock 0.255 2016-06-30 4 J 0 1579 A 2016-06-30 Common Stock 6192 54212 D No expiration date. The Series A Convertible Preferred Stock and Warrants were purchased together for the price of $1.00 per share. The Reporting Person received these shares as a payment-in-kind dividend. The Reporting Person received this Warrant in connection with a debt instrument. /s/ Donald A. Harris 2017-01-23