0001094891-19-000117.txt : 20190522 0001094891-19-000117.hdr.sgml : 20190522 20190522104856 ACCESSION NUMBER: 0001094891-19-000117 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190521 FILED AS OF DATE: 20190522 DATE AS OF CHANGE: 20190522 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shape Andrew CENTRAL INDEX KEY: 0001748801 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37808 FILM NUMBER: 19844598 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 2019-05-21 0001629261 Long Blockchain Corp. LBCC 0001748801 Shape Andrew C/O LONG BLOCKCHAIN CORP. 12-1 DUBON COURT FARMINGDALE NY 11735 1 1 0 0 Chief Executive Officer Warrant (Right to Buy) .25 2019-05-21 4 A 0 2000000 0 A 2019-01-18 2023-01-17 Common Stock 2000000 2000000 D /s/ Andy Shape 2019-05-22