Initial Statement of Beneficial Ownership (3)
April 06 2021 - 9:20AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
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3235-0104
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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GO EK Ventures IV, LLC |
2. Date of Event Requiring Statement (MM/DD/YYYY)
3/30/2021
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3. Issuer Name and Ticker or Trading Symbol
EASTMAN KODAK CO [KODK]
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(Last)
(First)
(Middle)
7632 COUNTY ROAD 42 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director ___X___ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Street)
VICTOR, NY 14564
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
___ Form filed by One Reporting Person
_X_ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
5.00% Series C Convertible Preferred Stock | 3/30/2021 | (1) | Common Stock | 10054513 (2) | $10 (3) | D (4) | |
Explanation of Responses: |
(1) | The 5.00% Series C Convertible Preferred Stock is convertible into Common Stock at any time on a ten-for-one basis and has no expiration date. |
(2) | Includes 54,513 shares of 5.00% Series C Convertible Preferred Stock payable as a payment-in-kind dividend on April 15, 2021. |
(3) | The initial conversion price is subject to certain customary anti-dilution adjustments and to proportional increase in the event the liquidation preference of the 5.00% Convertible Preferred Stock is increased. |
(4) | Owned directly by GO EK Ventures IV, LLC and indirectly by its sole member, B. Thomas Golisano. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
GO EK Ventures IV, LLC 7632 COUNTY ROAD 42 VICTOR, NY 14564 |
| X |
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GOLISANO B THOMAS
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| X |
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Signatures
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Matthew Ray, POA | | 4/5/2021 |
**Signature of Reporting Person | Date |
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