0001096906-17-000697.txt : 20171030 0001096906-17-000697.hdr.sgml : 20171030 20171030182156 ACCESSION NUMBER: 0001096906-17-000697 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170829 FILED AS OF DATE: 20171030 DATE AS OF CHANGE: 20171030 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KOSOWSKY J ALLEN CENTRAL INDEX KEY: 0000925327 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-53979 FILM NUMBER: 171163606 MAIL ADDRESS: STREET 1: C/O THOR INDUSTRIES, INC. STREET 2: 419 WEST PIKE STREET CITY: JACKSON CENTER STATE: OH ZIP: 45334-0629 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BlackRidge Technology International, Inc. CENTRAL INDEX KEY: 0001456212 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 000000000 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 10615 PROFESSIONAL CIRCLE, SUITE 201 CITY: RENO STATE: NV ZIP: 89521 BUSINESS PHONE: 855-807-8776 MAIL ADDRESS: STREET 1: 10615 PROFESSIONAL CIRCLE, SUITE 201 CITY: RENO STATE: NV ZIP: 89521 FORMER COMPANY: FORMER CONFORMED NAME: GROTE MOLEN, INC. DATE OF NAME CHANGE: 20170605 FORMER COMPANY: FORMER CONFORMED NAME: GROTE MOLEN INC DATE OF NAME CHANGE: 20090212 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2017-08-29 0 0001456212 BlackRidge Technology International, Inc. BRTI 0000925327 KOSOWSKY J ALLEN 10615 PROFESSIONAL CIRCLE, SUITE 201 RENO NV 89521 1 0 0 0 Common Stock 2017-08-29 4 A 0 44445 0.45 A 127778 D Common Stock 2017-09-11 4 A 0 198334 0.6 A 198334 D Warrant 0.6 2017-08-29 4 A 0 0 0 A 2017-08-29 2022-08-29 cs 44445 44445 D On September 11, 2017, the Company issued restricted common stock to its employees and affiliates in lieu of cash payment of deferred wages and compensation at $0.60 per restricted common share. The restricted common stock is restricted from sale for ten months from the date of issue. /s/ J. Allen Kosowsky 2017-10-30