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