0001144204-15-058416.txt : 20151007
0001144204-15-058416.hdr.sgml : 20151007
20151007150746
ACCESSION NUMBER: 0001144204-15-058416
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20151005
FILED AS OF DATE: 20151007
DATE AS OF CHANGE: 20151007
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: TWINLAB CONSOLIDATED HOLDINGS, INC.
CENTRAL INDEX KEY: 0001590695
STANDARD INDUSTRIAL CLASSIFICATION: MEDICINAL CHEMICALS & BOTANICAL PRODUCTS [2833]
IRS NUMBER: 463951742
STATE OF INCORPORATION: NV
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 632 BROADWAY
STREET 2: SUITE 201
CITY: NEW YORK
STATE: NY
ZIP: 10012
BUSINESS PHONE: (212) 651-8500
MAIL ADDRESS:
STREET 1: 632 BROADWAY
STREET 2: SUITE 201
CITY: NEW YORK
STATE: NY
ZIP: 10012
FORMER COMPANY:
FORMER CONFORMED NAME: MIRROR ME, INC.
DATE OF NAME CHANGE: 20131031
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Van Andel David L
CENTRAL INDEX KEY: 0001620362
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55181
FILM NUMBER: 151148766
MAIL ADDRESS:
STREET 1: 3133 ORCHARD VISTA DRIVE SE
CITY: GRAND RAPIDS
STATE: MI
ZIP: 49546
4
1
v421602_4.xml
OWNERSHIP DOCUMENT
X0306
4
2015-10-05
0
0001590695
TWINLAB CONSOLIDATED HOLDINGS, INC.
TLCC
0001620362
Van Andel David L
3133 ORCHARD VISTA DRIVE SE
GRAND RAPIDS
MI
49546
1
0
1
0
Put Option (right to sell)
0.385
2015-10-05
4
E
0
1
0
D
2015-10-15
2016-03-15
Common stock, par value $0.001
12987012
0
I
Owned through a Trust
The Put Option terminated upon the (a) the Issuer's closing of the transaction to purchase the equity interests of Organic Holdings, LLC pursuant to the Unit Purchase Agreement previously referenced in the Current Report on Form 8-K filed by the Issuer with the Securities and Exchange Commission on August 19, 2015, as the same may be amended by the parties thereto; and (b) the purchase by one or more investors of the Issuer's common stock, in an aggregate amount of at least $25,000,000, including both the purchase price paid for any common stock as well as the exercise price of any contingent warrants issued in connection therewith, assuming full exercise thereof.
The Put Option was issued to the David L. Van Andel Trust u/a dated November 30, 1993 ("DVA Trust") pursuant to a Put Agreement Related To Exercise of Warrant 2015-17, dated as of September 9, 2015.
The Put Option was owned by the DVA Trust.
/s/ David L. Van Andel
2015-10-07