0001545202-12-000002.txt : 20120322 0001545202-12-000002.hdr.sgml : 20120322 20120322161410 ACCESSION NUMBER: 0001545202-12-000002 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120307 FILED AS OF DATE: 20120322 DATE AS OF CHANGE: 20120322 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rosen Steven CENTRAL INDEX KEY: 0001545202 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-00147 FILM NUMBER: 12709449 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 3 1 primary_doc.xml PRIMARY DOCUMENT X0204 3 2012-03-07 0 0000047307 HICKOK INC HICKA 0001545202 Rosen Steven 25101 CHAGRIN BOULEVARD SUITE 350 BEACHWOOD OH 44122 1 0 1 0 Class B Common shares, $1.00 par value 20000 I Beneficial control of Roundball, LLC. Class A Common shares, $1.00 par value 194733 I Beneficial control of Roundball, LLC. Convertible Promissory Note 1.85 2011-12-30 2012-12-30 Class A Common shares, $1.00 par value 126184 I Beneficial control of Roundball, LLC. Convertible Loan Agreement 1.85 2011-12-30 2012-12-30 Class A Common shares, $1.00 par value 252368 I Beneficial control of Roundball, LLC. /s/ Steven H. Rosen 2012-03-22