0001144204-18-003991.txt : 20180126
0001144204-18-003991.hdr.sgml : 20180126
20180126153003
ACCESSION NUMBER: 0001144204-18-003991
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171020
FILED AS OF DATE: 20180126
DATE AS OF CHANGE: 20180126
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SHEFTS MARK
CENTRAL INDEX KEY: 0001270809
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37899
FILM NUMBER: 18551649
MAIL ADDRESS:
STREET 1: 160 SUMMIT AVE
CITY: MONTVALE
STATE: NJ
ZIP: 07645
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Alliance MMA, Inc.
CENTRAL INDEX KEY: 0001674227
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISCELLANEOUS AMUSEMENT & RECREATION [7990]
IRS NUMBER: 475412331
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 590 MADISON AVENUE
CITY: NEW YORK
STATE: NY
ZIP: 10022
BUSINESS PHONE: 2127397825
MAIL ADDRESS:
STREET 1: 590 MADISON AVENUE
CITY: NEW YORK
STATE: NY
ZIP: 10022
4
1
tv484195_4.xml
OWNERSHIP DOCUMENT
X0306
4
2017-10-20
0
0001674227
Alliance MMA, Inc.
AMMA
0001270809
SHEFTS MARK
C/O ALLIANCE MMA, INC.
590 MADISON AVENUE, 21ST FLOOR
NEW YORK
NY
10022
1
0
0
0
Common Stock par value $0.001
2017-10-20
4
P
0
183486
200000
A
373763
D
In addition to the 38,888 shares of common stock held directly, also includes 151,389 shares held by the Rushcap Group, Inc., of which Mr. Shefts and his spouse, Wanda Shefts, are the sole stockholders. Mr. Shefts has voting and dispositive power over the shares held by the Rushcap Group, Inc.
/s/ Mark Shefts
2018-01-26