0001144204-15-022647.txt : 20150414 0001144204-15-022647.hdr.sgml : 20150414 20150414141622 ACCESSION NUMBER: 0001144204-15-022647 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150410 FILED AS OF DATE: 20150414 DATE AS OF CHANGE: 20150414 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: NY FISCAL YEAR END: 0531 BUSINESS ADDRESS: STREET 1: 641 LEXINGTON AVENUE STREET 2: SUITE 1526 CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 212-634-6462 MAIL ADDRESS: STREET 1: 641 LEXINGTON AVENUE STREET 2: SUITE 1526 CITY: NEW YORK STATE: NY ZIP: 10022 FORMER COMPANY: FORMER CONFORMED NAME: GOLDEN FORK CORP DATE OF NAME CHANGE: 20100820 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mayer Robert Oscar CENTRAL INDEX KEY: 0001587443 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54515 FILM NUMBER: 15768930 MAIL ADDRESS: STREET 1: 15122 EL CAMINO REAL CITY: DEL MAR STATE: CA ZIP: 92014 4 1 v407244_4.xml OWNERSHIP DOCUMENT X0306 4 2015-04-10 0 0001499717 Staffing 360 Solutions, Inc. STAF 0001587443 Mayer Robert Oscar C/O STAFFING 360 SOLUTIONS, INC. 641 LEXINGTON AVE, SUITE 1526 NEW YORK NY 10022 1 0 0 0 Common Stock, $0.00001 par value per share 2015-04-10 4 A 0 650 A 839 I By Seven Investre, LLC These shares were issued as additional consideration in connection with the issuance of promissory notes to Seven Investre, LLC. The reporting person is a member of Seven Investre, LLC ("SI"). The listed amount of securities beneficially owned by the reporting person reflects the reporting person's ownership percentage in SI. The reporting person disclaims beneficial ownership of the securities held by SI, except to the extent of his pecuniary interest therein. /s/ Robert Oscar Mayer 2015-04-10