INTELLINETICS, INC. — Director's Dealing 2016

Dec 2, 2016

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: INTELLINETICS, INC. (INLX)
CIK: 0001081745
Period of Report: 2016-11-30

Reporting Person: TAGLICH MICHAEL N (10% Owner)

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2016-11-30	Warrant	$0.68	P	25000	Acquired	2021-12-01	Common stock (25000)	Direct
2016-11-30	Convertible Note	$	P		Acquired		Common stock ()	Direct

Footnotes

F1: Convertible Note is convertible into any equity securities next issued by the Company to investors on the same terms sold to other investors.

F2: N/A

F3: Total shares beneficially owned will be 1,250,168, plus any equity securities into which this note is convertible, based on as yet undetermined pricing.