Sec Form 4 Filing - HARRIS DONALD A @ CREATIVE REALITIES, INC. - 2015-02-18

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
HARRIS DONALD A
2. Issuer Name and Ticker or Trading Symbol
CREATIVE REALITIES, INC. [ CREX]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O NFINANSE INC., 3923 COCONUT PALM DRIVE, STE 107
3. Date of Earliest Transaction (MM/DD/YY)
02/18/2015
(Street)
TAMPA, FL33619
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 1,715,815 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Series A Convertible Preferred Stock $ 0.255 02/18/2015 P 50,000 02/18/2015 ( 1 ) Common Stock 196,078 $ 1 ( 2 ) 50,000 D
Warrants to purchase Common Stock $ 0.5 02/18/2015 P 62,500 02/18/2015 02/18/2020 Common Stock 62,500 ( 2 ) 62,500 D
Series A Convertible Preferred Stock $ 0.255 06/30/2015 J( 3 ) 1,100 06/30/2015 ( 1 ) Common Stock 4,314 ( 3 ) 51,100 D
Series A Convertible Preferred Stock $ 0.255 12/31/2015 J( 3 ) 1,533 12/31/2015 ( 1 ) Common Stock 6,012 ( 3 ) 52,633 D
Warrants to purchase Common Stock $ 0.28 06/13/2016 J( 4 ) 357,143 06/13/2016 06/13/2021 Common Stock 357,143 ( 4 ) 357,143 D
Series A Convertible Preferred Stock $ 0.255 06/30/2016 J( 4 ) 1,579 06/30/2016 ( 1 ) Common Stock 6,192 ( 3 ) 54,212 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
HARRIS DONALD A
C/O NFINANSE INC.
3923 COCONUT PALM DRIVE, STE 107
TAMPA, FL33619
X
Signatures
/s/ Donald A. Harris 01/23/2017
Signature of Reporting Person Date
Explanation of Responses:
( 1 )No expiration date.
( 2 )The Series A Convertible Preferred Stock and Warrants were purchased together for the price of $1.00 per share.
( 3 )The Reporting Person received these shares as a payment-in-kind dividend.
( 4 )The Reporting Person received this Warrant in connection with a debt instrument.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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