Sec Form 4 Filing - SCHILLER LEONARD M @ Jerrick Media Holdings, Inc. - 2017-08-25

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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
SCHILLER LEONARD M
2. Issuer Name and Ticker or Trading Symbol
Jerrick Media Holdings, Inc. [ JMDA]
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)
1110 N LAKE SHORE DR., APT. 9 SOUTH
3. Date of Earliest Transaction (MM/DD/YY)
08/25/2017
(Street)
CHICAGO, IL60611
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, par value $0.001 per share 08/31/2018 C 978,293 A $ 0.164 979,657 I By Leonard M. Schiller Revocable Trust Dtd. 10/3/1997
Common Stock, par value $0.001 per share 08/31/2018 C 144,323 A $ 0.2 1,123,980 I By Leonard M. Schiller Revocable Trust Dtd. 10/3/1997
Common Stock, par value $0.001 per share 08/31/2018 C 136,094 A $ 0.2 1,260,074 I By Leonard M. Schiller Revocable Trust Dtd. 10/3/1997
Common Stock, par value $0.001 per share 08/31/2018 C 521,848 A $ 0.2 1,781,922 I By Leonard M. Schiller Revocable Trust Dtd. 10/3/1997
Common Stock, par value $0.001 per share 08/31/2018 C 505,897 A 555,897 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 Cumulative Convertible Preferred Stock $ 0.164 08/31/2018 08/31/2018 C 1,364 ( 1 ) ( 1 ) Common Stock 978,293 ( 1 ) 0 I By Leonard M. Schiller Revocable Trust Dtd. 10/3/1997
Convertible Promissory Note $ 0.2 08/25/2017 C 144,323 ( 1 ) ( 1 ) Common Stock 144,323 ( 1 ) 0 I By Leonard M. Schiller Revocable Trust Dtd. 10/3/1997
Convertible Promissory Note $ 0.2 01/30/2018 C 136,094 ( 1 ) ( 1 ) Common Stock 136,094 ( 1 ) 0 I By Leonard M. Schiller Revocable Trust Dtd. 10/3/1997
Convertible Promissory Note $ 0.2 10/19/2017 C 505,897 ( 1 ) ( 1 ) Common Stock 505,897 ( 1 ) 0 D
Warrant to Purchase Common Stock $ 0.3 08/31/2018 A 890,280 08/31/2018 08/31/2023 Common Stock 890,280 ( 1 ) 890,280 I By Leonard M. Schiller Revocable Trust Dtd. 10/3/1997
Warrant to Purchase Common Stock $ 0.3 08/31/2018 A 252,949 08/31/2018 08/31/2023 Common Stock 252,949 ( 1 ) 252,949 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
SCHILLER LEONARD M
1110 N LAKE SHORE DR.
APT. 9 SOUTH
CHICAGO, IL60611
X
Signatures
/s/ Leonard Schiller 09/11/2018
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Effective August 31, 2018 Jerrick Media Holdings, Inc. (the "Company") entered into various letter agreements (the "Letter Agreements") with Mr. Leonard Schiller whereby the Company issued to Mr. Schiller an aggregate of 2,286,455 shares of common stock upon the conversion of outstanding shares preferred stock and debt securities held by Mr. Schiller. Further, as inducement to enter into the Letter Agreements, Mr. Schiller was issued two warrants to purchase an aggregate of 1,143,229 shares of the Company's common stock with an exercise price of $0.30 per share. No money was paid to the Company for the foregoing transactions.

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