0000905716-13-000002.txt : 20130102 0000905716-13-000002.hdr.sgml : 20130101 20130102143011 ACCESSION NUMBER: 0000905716-13-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121230 FILED AS OF DATE: 20130102 DATE AS OF CHANGE: 20130102 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: 13501365 MAIL ADDRESS: STREET 1: 25101 CHAGRIN BOULEVARD SUITE 350 CITY: BEACHWOOD STATE: OH ZIP: 44122 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 primary_doc.xml PRIMARY DOCUMENT X0306 4 2012-12-30 0 0000047307 HICKOK INC HICKA 0001545202 Rosen Steven 25101 CHAGRIN BOULEVARD SUITE 350 BEACHWOOD OH 44122 1 0 1 0 Warrant to Purchase Class A Common Stock 2.5 2012-12-30 4 P 0 100000 A 2012-12-30 2015-12-30 Class A Common Stock 100000 100000 I Beneficial control of Roundball, LLC. 1. In partial consideration for Amendment No. 1 to the Convertible Loan Agreement between the parties thereto, Hickok Incorporated (the "Company") and Roundball LLC ("Roundball") entered into a Warrant Agreement, dated December 30, 2012 (the "Roundball Warrant Agreement"), whereby the Company issued a warrant to Roundball to purchase, at its option, up to 100,000 shares of Class A Common Stock of the Company at an exercise price of $2.50 per share, subject to anti-dilution and other adjustments. /s/ Steven H. Rosen 2013-01-02