0001571049-17-007971.txt : 20170919
0001571049-17-007971.hdr.sgml : 20170919
20170919193718
ACCESSION NUMBER: 0001571049-17-007971
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170918
FILED AS OF DATE: 20170919
DATE AS OF CHANGE: 20170919
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: 171093075
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: 171093076
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: NY
FISCAL YEAR END: 1231
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
t1700505_jackson0918.xml
FORM 4
X0306
4
2017-09-18
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
2017-09-18
4
J
0
2250000
0.00
A
9411019
D
On September 18, 2017, Jackson Investment Group, LLC ("JIG LLC") acquired 2,250,000 shares of Common Stock as a commitment fee in connection with the acquisition by JIG LLC of a $40,000,000 senior secured note of the Issuer with a maturity date of September 15, 2020.
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 does not include 721 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, Manager and CEO
2017-09-19
/s/ Richard L. Jackson
2017-09-19