0001213900-15-001958.txt : 20150320
0001213900-15-001958.hdr.sgml : 20150320
20150320181456
ACCESSION NUMBER: 0001213900-15-001958
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150304
FILED AS OF DATE: 20150320
DATE AS OF CHANGE: 20150320
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: INTERCLOUD SYSTEMS, INC.
CENTRAL INDEX KEY: 0001128725
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
IRS NUMBER: 650963722
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 331 NEWMAN SPRINGS ROAD
STREET 2: BUILDING 1, SUITE 104
CITY: RED BANK
STATE: NJ
ZIP: 07701
BUSINESS PHONE: 561-988-1988
MAIL ADDRESS:
STREET 1: 331 NEWMAN SPRINGS ROAD
STREET 2: BUILDING 1, SUITE 104
CITY: RED BANK
STATE: NJ
ZIP: 07701
FORMER COMPANY:
FORMER CONFORMED NAME: GENESIS GROUP HOLDINGS INC
DATE OF NAME CHANGE: 20090401
FORMER COMPANY:
FORMER CONFORMED NAME: GENESIS REALTY GROUP INC
DATE OF NAME CHANGE: 20011002
FORMER COMPANY:
FORMER CONFORMED NAME: I REALTYAUCTION COM INC
DATE OF NAME CHANGE: 20001121
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SHOOKER DOUGLAS R
CENTRAL INDEX KEY: 0000926736
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36100
FILM NUMBER: 15717308
4
1
f4032015shooker_intercloud.xml
OWNERSHIP DOCUMENT
X0306
4
2015-03-04
0
0001128725
INTERCLOUD SYSTEMS, INC.
ICLD
0000926736
SHOOKER DOUGLAS R
1416 NORTH DONNELLY
MT. DORA
FL
32757
0
0
1
0
Common Stock
2014-10-19
4
P
0
75000
A
994228
I
See Footnote
Convertible Promissory Note
6.36
2015-03-04
4
P
0
748942
11238272
A
Common Stock
748942
1767024
I
See Footnote
Represents shares owned by Forward Investments LLC and the Reporting Person. The Reporting Person beneficially owns the shares held by Forward Investments LLC.
Represents shares of common stock issued to Forward Investments LLC in connection with the restructuring of debt extended by Forward Investments LLC to the Issuer, in order to extend the maturity dates thereof, reduce the seniority and reduce the interest rate accruing thereon, as well as shares of common stock issued to Forward Investments LLC in lieu of cash interest.
Immediately exercisable.
Expiration dates range from July 1, 2016, to January 1, 2018.
/s/ Douglas Shooker
2015-03-20