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