0001094891-18-000057.txt : 20180220
0001094891-18-000057.hdr.sgml : 20180220
20180220184959
ACCESSION NUMBER: 0001094891-18-000057
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180220
FILED AS OF DATE: 20180220
DATE AS OF CHANGE: 20180220
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Malik Shamyl
CENTRAL INDEX KEY: 0001727582
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37808
FILM NUMBER: 18626438
MAIL ADDRESS:
STREET 1: C/O LONG BLOCKCHAIN CORP.
STREET 2: 12-1 DUBON COURT
CITY: FARMINGDALE
STATE: NY
ZIP: 11735
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Long Blockchain Corp.
CENTRAL INDEX KEY: 0001629261
STANDARD INDUSTRIAL CLASSIFICATION: BEVERAGES [2080]
IRS NUMBER: 472624098
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 12-1 DUBON COURT
CITY: FARMINGDALE
STATE: NY
ZIP: 11735
BUSINESS PHONE: (855) 542-2832
MAIL ADDRESS:
STREET 1: 12-1 DUBON COURT
CITY: FARMINGDALE
STATE: NY
ZIP: 11735
FORMER COMPANY:
FORMER CONFORMED NAME: Long Island Iced Tea Corp.
DATE OF NAME CHANGE: 20141224
4
1
edgar.xml
PRIMARY DOCUMENT
X0306
4
2018-02-20
0001629261
Long Blockchain Corp.
LBCC
0001727582
Malik Shamyl
C/O LONG BLOCKCHAIN CORP.
12-1 DUBON COURT
FARMINGDALE
NY
11735
1
1
0
0
Chief Executive Officer
Common Stock
2018-02-20
4
A
0
41667
0
A
41667
D
Represents shares of the Issuer's common stock to be issued to the reporting person pursuant to an employment agreement entered into by and between the Issuer and the reporting person on February 20, 2018. Pursuant to the employment agreement, the reporting person is to receive his base salary for the first six months of the agreement in shares of common stock valued at $3.00 per share. The compensation is to be paid in 21 equal bi-monthly installments and vests on the later of the installment date or January 1, 2019, provided that the reporting person is still then employed by the Issuer.
/s/ Shamyl Malik
2018-02-20