0001415889-19-000803.txt : 20190625 0001415889-19-000803.hdr.sgml : 20190625 20190625190250 ACCESSION NUMBER: 0001415889-19-000803 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190621 FILED AS OF DATE: 20190625 DATE AS OF CHANGE: 20190625 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Keller Michael R CENTRAL INDEX KEY: 0001768576 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38819 FILM NUMBER: 19919667 MAIL ADDRESS: STREET 1: 2906 COLORADO AVE CITY: SANTA MONICA STATE: CA ZIP: 90404 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Super League Gaming, Inc. CENTRAL INDEX KEY: 0001621672 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-AMUSEMENT & RECREATION SERVICES [7900] IRS NUMBER: 471990734 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2906 COLORADO AVE CITY: SANTA MONICA STATE: CA ZIP: 90404 BUSINESS PHONE: 802-294-2754 MAIL ADDRESS: STREET 1: 2906 COLORADO AVE CITY: SANTA MONICA STATE: CA ZIP: 90404 FORMER COMPANY: FORMER CONFORMED NAME: Nth Games, Inc. DATE OF NAME CHANGE: 20141007 4 1 form4-06252019_040637.xml X0306 4 2019-06-21 0001621672 Super League Gaming, Inc. SLGG 0001768576 Keller Michael R C/O SUPER LEAGUE GAMING, INC. 2906 COLORADO AVE. SANTA MONICA CA 90404 true false false false Common Stock 2009-06-21 4 P 0 3300 8.0709 A 100301 I By the Michael R. Keller Trust Common Stock 2854 I By the Keller 2004 IRR Trust FBO William Common Stock 2854 I By the Keller 2004 IRR Trust FBO Charles Common Stock Purchase Warrant 9.35 2018-05-28 2023-05-28 Common Stock 54465 54465 I By the Michael R. Keller Trust Common Stock Purchase Warrant 9.35 2018-05-30 2023-05-30 Common Stock 10696 10696 I By the Michael R. Keller Trust Common Stock Purchase Warrant 9.35 2018-08-17 2023-08-17 Common Stock 21070 21070 I By the Michael R. Keller Trust Common Stock Purchase Warrant 10.80 2018-03-14 2023-03-14 Common Stock 9260 9260 I By the Michael R. Keller Trust Common Stock Purchase Warrant 9.35 2018-08-17 2023-08-17 Common Stock 2674 2674 I By the Keller 2004 IRR Trust FBO William Common Stock Purchase Warrant 9.35 2018-08-17 2023-08-17 Common Stock 2674 2674 I By the Keller 2004 IRR Trust FBO Charles Includes 91,546 shares issued to the Michael R. Keller Trust (the "Keller Trust") upon conversion of 9.00% Secured Convertible Promissory Notes (the "Notes") previously issued to the Keller Trust. The outstanding principal and all accrued but unpaid interest on the Notes were automatically converted into shares of the Issuer's common stock in connection with the Issuer's initial public offering on February 27, 2019. Includes 2,854 shares issued to the Keller 2004 IRR Trust FBO William (the "FBO William Trust") upon conversion of 9.00% Secured Convertible Promissory Notes (the "Notes") previously issued to the FBO William Trust. The outstanding principal and all accrued but unpaid interest on the Notes were automatically converted into shares of the Issuer's common stock in connection with the Issuer's initial public offering on February 27, 2019. Includes 2,854 shares issued to the Keller 2004 IRR Trust FBO Charles (the "FBO Charles Trust") upon conversion of 9.00% Secured Convertible Promissory Notes (the "Notes") previously issued to the FBO Charles Trust. The outstanding principal and all accrued but unpaid interest on the Notes were automatically converted into shares of the Issuer's common stock in connection with the Issuer's initial public offering on February 27, 2019. /s/ Clayton Haynes, Attorney-in-Fact 2019-06-25