0001683168-16-000831.txt : 20161201 0001683168-16-000831.hdr.sgml : 20161201 20161201204855 ACCESSION NUMBER: 0001683168-16-000831 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161129 FILED AS OF DATE: 20161201 DATE AS OF CHANGE: 20161201 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PRECISION OPTICS CORPORATION, INC. CENTRAL INDEX KEY: 0000867840 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 042795294 STATE OF INCORPORATION: MA FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 22 EAST BROADWAY CITY: GARDNER STATE: MA ZIP: 01440 BUSINESS PHONE: 978-630-1800 MAIL ADDRESS: STREET 1: 22 EAST BROADWAY CITY: GARDNER STATE: MA ZIP: 01440 FORMER COMPANY: FORMER CONFORMED NAME: PRECISION OPTICS Corp INC DATE OF NAME CHANGE: 20111027 FORMER COMPANY: FORMER CONFORMED NAME: PRECISION OPTICS CORPORATION INC DATE OF NAME CHANGE: 19930328 FORMER COMPANY: FORMER CONFORMED NAME: PRECISION OPTICS CORP INC DATE OF NAME CHANGE: 19600201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Forkey Joseph Norman CENTRAL INDEX KEY: 0001360197 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10647 FILM NUMBER: 162029658 MAIL ADDRESS: STREET 1: C/O PRECISION OPTICS CORPORATION INC STREET 2: 22 EAST BROADWAY CITY: GARDNER STATE: MA ZIP: 01440 4 1 precision-forkey_f4.xml OWNERSHIP DOCUMENT X0306 4 2016-11-29 0 0000867840 PRECISION OPTICS CORPORATION, INC. PEYE 0001360197 Forkey Joseph Norman PRECISION OPTICS CORPORATION, INC. 22 EAST BROADWAY GARDNER MA 01440 1 1 0 0 Chief Executive Officer Warrants 0.97 2016-11-29 4 J 0 4470 A 2012-09-28 2017-09-28 Common Stock 4470 20027 D On November 22, 2016, the issuer sold 1,333,334 units consisting of shares of common stock and warrants in a private placement. Mr. Forkey purchased 15,557 warrants in a private placement on September 28, 2012 with an original exercise price of $1.25 per share. The new warrants were issued as a result of the November 2016 private placement triggering certain anti-dilution provisions in these original warrants. In connection therewith, the exercise price of the September 2012 warrants decreased to $0.97 per share accordingly. /s/ Joseph Forkey 2016-12-01