0001104659-20-003964.txt : 20200114
0001104659-20-003964.hdr.sgml : 20200114
20200114170009
ACCESSION NUMBER: 0001104659-20-003964
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191111
FILED AS OF DATE: 20200114
DATE AS OF CHANGE: 20200114
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jackson Investment Group, LLC
CENTRAL INDEX KEY: 0001571267
STATE OF INCORPORATION: GA
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37575
FILM NUMBER: 20526525
BUSINESS ADDRESS:
STREET 1: 2655 NORTHWINDS PARKWAY
CITY: ALPHARETTA
STATE: GA
ZIP: 30009
BUSINESS PHONE: 770-643-5529
MAIL ADDRESS:
STREET 1: 2655 NORTHWINDS PARKWAY
CITY: ALPHARETTA
STATE: GA
ZIP: 30009
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jackson Richard Lee
CENTRAL INDEX KEY: 0001572666
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37575
FILM NUMBER: 20526526
MAIL ADDRESS:
STREET 1: 2655 NORTHWINDS PARKWAY
CITY: ALPHARETTA
STATE: GA
ZIP: 30009
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Staffing 360 Solutions, Inc.
CENTRAL INDEX KEY: 0001499717
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HELP SUPPLY SERVICES [7363]
IRS NUMBER: 680680859
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1228
BUSINESS ADDRESS:
STREET 1: 641 LEXINGTON AVENUE
STREET 2: 27TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
BUSINESS PHONE: 646-507-5710
MAIL ADDRESS:
STREET 1: 641 LEXINGTON AVENUE
STREET 2: 27TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
FORMER COMPANY:
FORMER CONFORMED NAME: GOLDEN FORK CORP
DATE OF NAME CHANGE: 20100820
4
1
tm203303-1_form4.xml
OWNERSHIP DOCUMENT
X0306
4
2019-11-11
0
0001499717
Staffing 360 Solutions, Inc.
STAF
0001571267
Jackson Investment Group, LLC
2655 NORTHWINDS PARKWAY
ALPHARETTA,
GA
30009
0
0
1
0
0001572666
Jackson Richard Lee
2655 NORTHWINDS PARKWAY
ALPHARETTA,
GA
30009
0
0
1
0
Common Stock
2019-11-11
4
J
0
100000
0.00
A
2474204
D
On November 11, 2019 Jackson Investment Group, LLC ("JIG LLC") acquired 100,000 shares of Common Stock in connection with and in consideration of its waiver of the Company's covenant default under that certain Amended and Restated Note Purchase Agreement, dated as of September 15, 2017, by and between JIG LLC, the Company and certain of its subsidiaries as guarantors, as amended (the "Covenant Waiver Transaction"). The Covenant Waiver Transaction was valued using the November 11, 2019 closing price of the Company's common stock.
Richard L. Jackson, the sole manager and controlling owner of JIG LLC, may be deemed the indirect beneficial owner, but he disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.
Total in Table 1, Item 5 does not include 144 shares of common stock personally owned by Richard L. Jackson, the chief executive officer of JIG LLC. These shares are directly and beneficially owned by Richard L. Jackson, one of the Reporting Persons; however, they are not owned by JIG LLC, the designated Reporting Person.
This form is filed by both JIG LLC and Richard L. Jackson, the sole manager and controlling owner of JIG LLC.
/s/ Jackson Investment Group, LLC, by Richard L. Jackson, CEO
2020-01-14
/s/ Richard L. Jackson
2020-01-14