0000899243-15-005644.txt : 20151001 0000899243-15-005644.hdr.sgml : 20151001 20151001095948 ACCESSION NUMBER: 0000899243-15-005644 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150929 FILED AS OF DATE: 20151001 DATE AS OF CHANGE: 20151001 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HICKOK INC CENTRAL INDEX KEY: 0000047307 STANDARD INDUSTRIAL CLASSIFICATION: INDUSTRIAL INSTRUMENTS FOR MEASUREMENT, DISPLAY, AND CONTROL [3823] IRS NUMBER: 340288470 STATE OF INCORPORATION: OH FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 10514 DUPONT AVE CITY: CLEVELAND STATE: OH ZIP: 44108 BUSINESS PHONE: 2165418060 MAIL ADDRESS: STREET 1: 10514 DUPONT AVE CITY: CLEVELAND STATE: OH ZIP: 44108 FORMER COMPANY: FORMER CONFORMED NAME: HICKOK ELECTRICAL INSTRUMENT CO DATE OF NAME CHANGE: 19920703 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rosen Steven CENTRAL INDEX KEY: 0001545202 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-00147 FILM NUMBER: 151135699 MAIL ADDRESS: STREET 1: 25101 CHAGRIN BOULEVARD SUITE 350 CITY: BEACHWOOD STATE: OH ZIP: 44122 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2015-09-29 0 0000047307 HICKOK INC HICKA 0001545202 Rosen Steven 25101 CHAGRIN BOULEVARD, SUITE 1350 BEACHWOOD OH 44122 1 0 1 0 Class B Common Shares, no par value 2015-09-29 2015-09-29 4 P 0 75000 1.50 A 115000 I See footnotes These shares are owned directly by Roundball LLC, an Ohio limited liability company ("Roundball"). For purposes of the Securities Exchange Act of 1934, the Reporting Person disclaims beneficial ownership of any securities, except to the extent of his pecuniary interest therein, if any, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities for purposes of Section 16 or otherwise. /s/ Fred Widen, Attorney-in-fact 2015-10-01