0001213900-17-008007.txt : 20170728
0001213900-17-008007.hdr.sgml : 20170728
20170728161439
ACCESSION NUMBER: 0001213900-17-008007
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170727
FILED AS OF DATE: 20170728
DATE AS OF CHANGE: 20170728
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KAYE BARRY C
CENTRAL INDEX KEY: 0001380633
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-33155
FILM NUMBER: 17990174
MAIL ADDRESS:
STREET 1: 15 SUSAN DRIVE
CITY: MARLBORO
STATE: NJ
ZIP: 07746
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: COATES INTERNATIONAL LTD \DE\
CENTRAL INDEX KEY: 0000948426
STANDARD INDUSTRIAL CLASSIFICATION: ENGINES & TURBINES [3510]
IRS NUMBER: 222925432
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: HIGHWAY 34 & RIDGEWOOD RD
CITY: WALL TOWNSHIP
STATE: NJ
ZIP: 07719
BUSINESS PHONE: 9084497717
MAIL ADDRESS:
STREET 1: HIGHWAY 34 & RIDGWOOD ROAD
CITY: WALL TOWNSHIP
STATE: NJ
ZIP: 07719
4
1
f4072717kaye_coatesintl.xml
OWNERSHIP DOCUMENT
X0306
4
2017-07-27
0
0000948426
COATES INTERNATIONAL LTD \DE\
COTE
0001380633
KAYE BARRY C
15 SUSAN DRIVE
MARLBORO
NJ
07746
1
1
0
0
Treasurer and CFO
Series B Convertible Preferred Stock
0
2017-07-27
5
A
0
E
25318
0
A
2019-07-27
Common Stock
25318000
165248
D
The anti-dilution award to Mr. Kaye was determined to be the number of shares of Series B required to maintain his ownership percentage of common
stock at 0.0478% of the pro forma number of shares of common stock outstanding, assuming all shares of Series B Convertible Preferred Stock are
converted to common stock. This was his weighted average percentage ownership of common stock purchased, based on the number of shares of
common stock outstanding on each date he acquired additional shares of common stock. The number of such shares issued was based on this program.
This anti-dilution program does not apply to exercises of employee stock options and common stock issued pursuant to a secondary public offering of
common stock. There is no expiration date.
Each share of Series B entitles the holder to 1,000 votes at any meeting where corporate matters are brought before the shareholders for a vote. The
Series B Convertible Preferred Stock is restricted, unregistered stock which is not convertible until the second annual anniversary after the date of issue,
after which each share is freely convertible into 1,000 restricted, unregistered shares of common stock. In the event of a sale or change of control of the
Corporation, the Series B shall become immediately convertible.
/s/ Barry C. Kaye
2017-07-28