0001104659-21-023138.txt : 20210216 0001104659-21-023138.hdr.sgml : 20210216 20210216091151 ACCESSION NUMBER: 0001104659-21-023138 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210212 FILED AS OF DATE: 20210216 DATE AS OF CHANGE: 20210216 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: 21633177 MAIL ADDRESS: STREET 1: 2655 NORTHWINDS PARKWAY CITY: ALPHARETTA STATE: GA ZIP: 30009 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: 21633178 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 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: 1226 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 tm216649-1_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2021-02-12 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 Series E Convertible Preferred Stock 1.00 2021-02-12 4 J 0 4518 4518000 D 2022-10-31 Common Stock 4518000 0 D The reported securities were called for redemption by the issuer at a price equal to their face value. The remaining shares of Series E Preferred Stock owned by the Reporting Person are not convertible into Common Stock until October 31, 2022 so are not included as being beneficially owned. The Reporting Person continues to beneficially own 1,407 shares of Series E-1 Preferred Stock. Richard L. Jackson, the sole manager and controlling owner of Jackson Investment Group, 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. /s/ Jackson Investment Group, LLC By: Richard L. Jackson, Manager and CEO 2021-02-16 /s/ Richard L. Jackson 2021-02-16