0000899243-18-000570.txt : 20180105
0000899243-18-000570.hdr.sgml : 20180105
20180105140538
ACCESSION NUMBER: 0000899243-18-000570
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171229
FILED AS OF DATE: 20180105
DATE AS OF CHANGE: 20180105
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CRAWFORD MATTHEW V
CENTRAL INDEX KEY: 0001132148
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-00147
FILM NUMBER: 18512988
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-12-29
0
0000047307
HICKOK INC
HICKA
0001132148
CRAWFORD MATTHEW V
10514 DUPONT AVE.
CLEVELAND
OH
44108
1
0
1
0
Class A Common Stock
1232168
I
See Footnote
Class A Common Stock
3000
D
Warrant to Purchase Class A Common Stock
2.50
2016-12-20
4
D
0
100000
D
2017-12-30
Class A Common Stock
100000
252367
I
See Footnote
Warrant to Purchase Class A Common Stock
2.50
2016-12-20
4
A
0
100000
A
2018-12-30
Class A Common Stock
100000
426489
I
See Footnote
Convertible Loan Agreement
1.85
2016-12-20
4
D
0
252367
D
2017-12-30
Class A Common Stock
252367
100000
I
See Footnote
Convertible Loan Agreement
1.85
2016-12-20
4
A
0
326489
A
2018-12-30
Class A Common Stock
326489
426489
I
See Footnote
The two reported transactions involved an amendment of an outstanding warrant, resulting in the deemed cancellation of the "old" warrant and the grant of a replacement warrant.
The two reported transactions involved an amendment of an outstanding convertible loan agreement, resulting in the deemed cancellation of the "old" convertible loan agreement and the entry into a replacement convertible loan agreement.
The securities reported herein are owned directly by Roundball LLC, an Ohio limited liability company. For purposes of the Securities Exchange Act of 1934, the Reporting Person disclaims beneficial ownership of any securities, except 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.
Includes 320,918 shares that are owned directly by Roundball LLC and 911,250 shares that are owned directly by First Francis Company Inc. The reporting person disclaims beneficial ownership of those shares except to the extent of his pecuniary interest therein.
/s/ Fred Widen, Attorney-in-fact
2018-01-05