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