0001144204-18-020657.txt : 20180416 0001144204-18-020657.hdr.sgml : 20180416 20180416142459 ACCESSION NUMBER: 0001144204-18-020657 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170829 FILED AS OF DATE: 20180416 DATE AS OF CHANGE: 20180416 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tracy Joel Daniel CENTRAL INDEX KEY: 0001684720 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37899 FILM NUMBER: 18756319 MAIL ADDRESS: STREET 1: 574 GLEN RIDGE DRIVE SOUTH CITY: BRIDGEWATER STATE: NJ ZIP: 08807 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Alliance MMA, Inc. CENTRAL INDEX KEY: 0001674227 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISCELLANEOUS AMUSEMENT & RECREATION [7990] IRS NUMBER: 475412331 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 590 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 2127397825 MAIL ADDRESS: STREET 1: 590 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10022 4/A 1 tv491138_form4a.xml OWNERSHIP DOCUMENT X0306 4/A 2017-08-29 2018-01-26 0 0001674227 Alliance MMA, Inc. AMMA 0001684720 Tracy Joel Daniel C/O ALLIANCE MMA, INC. 590 MADISON AVENUE, 21ST FLOOR NEW YORK NY 10022 1 0 0 0 Common Stock par value $0.001 2017-08-29 4 P 0 45872 50000 A 334860 D Warrant to Purchase Common Stock 1.50 2017-08-29 4 P 0 45872 A 2018-03-01 2020-08-28 Common Stock, par value $0.001 45872 45872 D Warrant to Purchase Common Stock 1.50 2018-03-01 2020-08-28 Common Stock, par value $0.001 25000 70872 I See Footnote Warrant to Purchase Common Stock 1.75 2018-03-01 2020-08-28 Common Stock, par value $0.001 100000 170872 I See Footnote In addition to the 184,860 shares of common stock held directly, also includes 150,000 shares held by relations of Mr. Tracy. Mr. Tracy has voting and disposition power over the shares. Fully vested warrants were issued in a prior reported purchase on the Form 4 filed on January 26, 2018. The warrants were issued at a rate of one warrant per one share of common stock at a unitprice of $1.09 per unit. In addition to the 45,872 warrants held directly, also includes 125,000 warrants held be relations to Mr. Tracy. Mr. Tracy has voting and disposition power over the warrants. The original Form 4, filed on January 26, 2018, is being amended by this Form 4 amendment to correct an administrative error, which misrepresented a purchase that occured on October 20, 2017,as a total of 45,872 shares of common stock, when in fact an equal number of warrants to purchase common stock were also included in that purchase, and the correct purchase date was August 29,2017. As a result of this administrative error, the number of derivative securites beneficially owned by the reporting person is 45,872. /s/ Joel Tracy 2018-04-11