0001179110-12-002498.txt : 20120214
0001179110-12-002498.hdr.sgml : 20120214
20120214161313
ACCESSION NUMBER: 0001179110-12-002498
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111231
FILED AS OF DATE: 20120214
DATE AS OF CHANGE: 20120214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BARRETT WILLIAM J
CENTRAL INDEX KEY: 0000923415
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-21609
FILM NUMBER: 12609912
MAIL ADDRESS:
STREET 1: P O BOX 6199
CITY: FAIR HAVEN
STATE: NJ
ZIP: 07704
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CHASE PACKAGING CORP
CENTRAL INDEX KEY: 0001025771
STANDARD INDUSTRIAL CLASSIFICATION: AGRICULTURE SERVICES [0700]
IRS NUMBER: 931216127
STATE OF INCORPORATION: NJ
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 636 RIVER ROAD
CITY: FAIRHAVEN
STATE: NJ
ZIP: 07704
BUSINESS PHONE: 732-741-1500
MAIL ADDRESS:
STREET 1: POB 6199
STREET 2: 636 RIVER ROAD
CITY: FAIRHAVEN
STATE: NJ
ZIP: 07704
5
1
edgar.xml
FORM 5 -
X0304
5
2011-12-31
0
0
0
0001025771
CHASE PACKAGING CORP
CPKA
0000923415
BARRETT WILLIAM J
P. O. BOX 6199
FAIR HAVEN
NJ
07704
1
1
1
0
Secretary
Series A 10% Convertible Preferred Stock
0.10
Common Stock
2732000
2732000
D
Series A 10% Convertible Preferred Stock
0.10
Common Stock
498000
498000
I
By Spouse
Currently exercisable.
Adjusted to reflect the annual 10% stock dividend paid by the Company to all holders of Series A Convertible Preferred Stock on December 1, 2010 and December 1, 2011.
Not applicable.
Reporting Person disclaims beneficial ownership of shares owned by spouse.
William J. Barrett
2012-02-14