Small Company Offering and Sale of Securities Without Registration (d)
Source: Edgar (US Regulatory)
UNITED STATES SECURITIES
AND EXCHANGE COMMISSION
Washington, D.C.
FORM D
OMB APPROVAL
OMB Number: 3235-0076
Estimated Average burden hours per response: 4.0
Notice of Exempt Offering of Securities
1. Issuer's Identity
CIK (Filer ID Number) Previous Name(s) x None Entity Type
0000869187
x Corporation
o Limited Partnership
o Limited Liability Company
o General Partnership
o Business Trust
o Other
Name of Issuer
BALTIA AIR LINES INC
Jurisdiction of Incorporation/Organization
NEW YORK
Year of Incorporation/Organization
x Over Five Years Ago
o Within Last Five Years (Specify Year)
o Yet to Be Formed
2. Principal Place of Business and Contact Information
Name of Issuer
BALTIA AIR LINES INC
Street Address 1 Street Address 2
BUILDING 151 - JFK INTERNATIONAL AIRPORT ROOM 361
City State/Province/Country ZIP/Postal Code Phone No. of Issuer
JAMAICA NEW YORK 11430 718-995-4130
3. Related Persons
Last Name First Name Middle Name
DMITROWSKY Igor
Street Address 1 Street Address 2
66-25 Saunders Street Apt 7-I
City State/Province/Country ZIP/Postal Code
Rego Park NEW YORK 11374
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
Chairman, President, CFO
Last Name First Name Middle Name
CLARE Barry
Street Address 1 Street Address 2
4310 215th Street
City State/Province/Country ZIP/Postal Code
Bayside NEW YORK 11361
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
Vice President of Finance
Last Name First Name Middle Name
THAL Rusell
Street Address 1 Street Address 2
25 Rdige Drive
City State/Province/Country ZIP/Postal Code
Port Washington NEW YORK 11050
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
Executive Vice President
Last Name First Name Middle Name
RUKMANIS Andris
Street Address 1 Street Address 2
Kundzinsalas 8, Line 9-2
City State/Province/Country ZIP/Postal Code
Riga LATVIA 00000
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
Last Name First Name Middle Name
BOLANOS Vick Luis
Street Address 1 Street Address 2
633 Monroe Street
City State/Province/Country ZIP/Postal Code
Riverside NEW YORK 08075
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
Last Name First Name Middle Name
KAPLINSKY Walter
Street Address 1 Street Address 2
2000 Quentin Road
City State/Province/Country ZIP/Postal Code
Brooklyn NEW YORK 11299
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
Corporate Secretary and Board Director
4. Industry Group
o Agriculture Health Care o Retailing
Banking & Financial Services o Biotechnology o Restaurants
o Commercial Banking o Health Insurance Technology
o Insurance o Hospitals & Physicians o Computers
o Investing o Pharmaceuticals o Telecommunications
o Investment Banking o Other Health Care o Other Technology
o Pooled Investment Fund
Travel
o Other Banking & Financial Services o Manufacturing x Airlines & Airports
Real Estate o Lodging & Conventions
o Commercial o Tourism & Travel Services
o Construction o Other Travel
o REITS & Finance o Other
o Residential
o Other Real Estate
o Business Services
Energy
o Coal Mining
o Electric Utilities
o Energy Conservation
o Environmental Services
o Oil & Gas
o Other Energy
5. Issuer Size
Revenue Range Aggregate Net Asset Value Range
x No Revenues o No Aggregate Net Asset Value
o $1 - $1,000,000 o $1 - $5,000,000
o $1,000,001 - $5,000,000 o $5,000,001 - $25,000,000
o $5,000,001 - $25,000,000 o $25,000,001 - $50,000,000
o $25,000,001 - $100,000,000 o $50,000,001 - $100,000,000
o Over $100,000,000 o Over $100,000,000
o Decline to Disclose o Decline to Disclose
o Not Applicable o Not Applicable
6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
o Rule 504(b)(1) (not (i), (ii) or (iii)) o Rule 505
o Rule 504 (b)(1)(i) o Rule 506(b)
o Rule 504 (b)(1)(ii) x Rule 506(c)
o Rule 504 (b)(1)(iii) o Securities Act Section 4(a)(5)
o Investment Company Act Section 3(c)
7. Type of Filing
x New Notice Date of First Sale x First Sale Yet to Occur
o Amendment
8. Duration of Offering
Does the Issuer intend this offering to last more than one year? o Yes x No
9. Type(s) of Securities Offered (select all that apply)
o Pooled Investment Fund Interests x Equity
o Tenant-in-Common Securities o Debt
o Mineral Property Securities o Option, Warrant or Other Right to Acquire Another Security
o Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security o Other (describe)
10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? o Yes x No
Clarification of Response (if Necessary)
11. Minimum Investment
Minimum investment accepted from any outside investor $ 20000 USD
12. Sales Compensation
Recipient Recipient CRD Number x None
BALTIA AIR LINES INC
(Associated) Broker or Dealer x None (Associated) Broker or Dealer CRD Number x None
Street Address 1 Street Address 2
Bldg 151 - JFK Intl Airport Room 361
City State/Province/Country ZIP/Postal Code
Jamaica NEW YORK 11430
State(s) of Solicitation x All States o Foreign/Non-US
13. Offering and Sales Amounts
Total Offering Amount $ 10000000 USD o Indefinite
Total Amount Sold $ 0 USD
Total Remaining to be Sold $ 10000000 USD o Indefinite
Clarification of Response (if Necessary)
14. Investors
o Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering
Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: 0
15. Sales Commissions & Finders' Fees Expenses
Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
Sales Commissions $ 0 USD o Estimate
Finders' Fees $ 0 USD o Estimate
Clarification of Response (if Necessary)
Issuer is acting without a broker or dealer, and will not pay commissions or finders fees.
16. Use of Proceeds
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
$ 250000 USD x Estimate
Clarification of Response (if Necessary)
Signature and Submission
Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice.
Terms of Submission
In submitting this notice, each Issuer named above is:
Notifying the SEC and/or each State in which this notice is filed of the offering of securities described and undertaking to furnish them, upon written request, the information furnished to offerees.
Irrevocably appointing each of the Secretary of the SEC and, the Securities Administrator or other legally designated officer of the State in which the Issuer maintains its principal place of business and any State in which this notice is filed, as its agents for service of process, and agreeing that these persons may accept service on its behalf, of any notice, process or pleading, and further agreeing that such service may be made by registered or certified mail, in any Federal or state action, administrative proceeding, or arbitration brought against it in any place subject to the jurisdiction of the United States, if the action, proceeding or arbitration (a) arises out of any activity in connection with the offering of securities that is the subject of this notice, and (b) is founded, directly or indirectly, upon the provisions of: (i) the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture Act of 1939, the Investment Company Act of 1940, or the Investment Advisers Act of 1940, or any rule or regulation under any of these statutes, or (ii) the laws of the State in which the issuer maintains its principal place of business or any State in which this notice is filed.
Certifying that the Issuer is not disqualified from relying on any Regulation D exemption it has identified in Item 6 above for one of the reasons stated in Rule 505(b)(2)(iii).
Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person.
For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature.
Issuer Signature Name of Signer Title Date
BALTIA AIR LINES INC Igor Dmitrowsky Igor Dmitrowsky President and CFO 2015-10-08
Source: Edgar (US Regulatory)
UNITED STATES SECURITIES
AND EXCHANGE COMMISSION
Washington, D.C.
FORM D
OMB APPROVAL
OMB Number: 3235-0076
Estimated Average burden hours per response: 4.0
Notice of Exempt Offering of Securities
1. Issuer's Identity
CIK (Filer ID Number) Previous Name(s) x None Entity Type
0000869187
x Corporation
o Limited Partnership
o Limited Liability Company
o General Partnership
o Business Trust
o Other
Name of Issuer
BALTIA AIR LINES INC
Jurisdiction of Incorporation/Organization
NEW YORK
Year of Incorporation/Organization
x Over Five Years Ago
o Within Last Five Years (Specify Year)
o Yet to Be Formed
2. Principal Place of Business and Contact Information
Name of Issuer
BALTIA AIR LINES INC
Street Address 1 Street Address 2
BUILDING 151 - JFK INTERNATIONAL AIRPORT ROOM 361
City State/Province/Country ZIP/Postal Code Phone No. of Issuer
JAMAICA NEW YORK 11430 718-995-4130
3. Related Persons
Last Name First Name Middle Name
DMITROWSKY Igor
Street Address 1 Street Address 2
66-25 Saunders Street Apt 7-I
City State/Province/Country ZIP/Postal Code
Rego Park NEW YORK 11374
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
Chairman, President, CFO
Last Name First Name Middle Name
CLARE Barry
Street Address 1 Street Address 2
4310 215th Street
City State/Province/Country ZIP/Postal Code
Bayside NEW YORK 11361
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
Vice President of Finance
Last Name First Name Middle Name
THAL Rusell
Street Address 1 Street Address 2
25 Rdige Drive
City State/Province/Country ZIP/Postal Code
Port Washington NEW YORK 11050
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
Executive Vice President
Last Name First Name Middle Name
RUKMANIS Andris
Street Address 1 Street Address 2
Kundzinsalas 8, Line 9-2
City State/Province/Country ZIP/Postal Code
Riga LATVIA 00000
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
Last Name First Name Middle Name
BOLANOS Vick Luis
Street Address 1 Street Address 2
633 Monroe Street
City State/Province/Country ZIP/Postal Code
Riverside NEW YORK 08075
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
Last Name First Name Middle Name
KAPLINSKY Walter
Street Address 1 Street Address 2
2000 Quentin Road
City State/Province/Country ZIP/Postal Code
Brooklyn NEW YORK 11299
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
Corporate Secretary and Board Director
4. Industry Group
o Agriculture Health Care o Retailing
Banking & Financial Services o Biotechnology o Restaurants
o Commercial Banking o Health Insurance Technology
o Insurance o Hospitals & Physicians o Computers
o Investing o Pharmaceuticals o Telecommunications
o Investment Banking o Other Health Care o Other Technology
o Pooled Investment Fund
Travel
o Other Banking & Financial Services o Manufacturing x Airlines & Airports
Real Estate o Lodging & Conventions
o Commercial o Tourism & Travel Services
o Construction o Other Travel
o REITS & Finance o Other
o Residential
o Other Real Estate
o Business Services
Energy
o Coal Mining
o Electric Utilities
o Energy Conservation
o Environmental Services
o Oil & Gas
o Other Energy
5. Issuer Size
Revenue Range Aggregate Net Asset Value Range
x No Revenues o No Aggregate Net Asset Value
o $1 - $1,000,000 o $1 - $5,000,000
o $1,000,001 - $5,000,000 o $5,000,001 - $25,000,000
o $5,000,001 - $25,000,000 o $25,000,001 - $50,000,000
o $25,000,001 - $100,000,000 o $50,000,001 - $100,000,000
o Over $100,000,000 o Over $100,000,000
o Decline to Disclose o Decline to Disclose
o Not Applicable o Not Applicable
6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
o Rule 504(b)(1) (not (i), (ii) or (iii)) o Rule 505
o Rule 504 (b)(1)(i) o Rule 506(b)
o Rule 504 (b)(1)(ii) x Rule 506(c)
o Rule 504 (b)(1)(iii) o Securities Act Section 4(a)(5)
o Investment Company Act Section 3(c)
7. Type of Filing
x New Notice Date of First Sale x First Sale Yet to Occur
o Amendment
8. Duration of Offering
Does the Issuer intend this offering to last more than one year? o Yes x No
9. Type(s) of Securities Offered (select all that apply)
o Pooled Investment Fund Interests x Equity
o Tenant-in-Common Securities o Debt
o Mineral Property Securities o Option, Warrant or Other Right to Acquire Another Security
o Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security o Other (describe)
10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? o Yes x No
Clarification of Response (if Necessary)
11. Minimum Investment
Minimum investment accepted from any outside investor $ 20000 USD
12. Sales Compensation
Recipient Recipient CRD Number x None
BALTIA AIR LINES INC
(Associated) Broker or Dealer x None (Associated) Broker or Dealer CRD Number x None
Street Address 1 Street Address 2
Bldg 151 - JFK Intl Airport Room 361
City State/Province/Country ZIP/Postal Code
Jamaica NEW YORK 11430
State(s) of Solicitation x All States o Foreign/Non-US
13. Offering and Sales Amounts
Total Offering Amount $ 10000000 USD o Indefinite
Total Amount Sold $ 0 USD
Total Remaining to be Sold $ 10000000 USD o Indefinite
Clarification of Response (if Necessary)
14. Investors
o Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering
Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: 0
15. Sales Commissions & Finders' Fees Expenses
Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
Sales Commissions $ 0 USD o Estimate
Finders' Fees $ 0 USD o Estimate
Clarification of Response (if Necessary)
Issuer is acting without a broker or dealer, and will not pay commissions or finders fees.
16. Use of Proceeds
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
$ 250000 USD x Estimate
Clarification of Response (if Necessary)
Signature and Submission
Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice.
Terms of Submission
In submitting this notice, each Issuer named above is:
Notifying the SEC and/or each State in which this notice is filed of the offering of securities described and undertaking to furnish them, upon written request, the information furnished to offerees.
Irrevocably appointing each of the Secretary of the SEC and, the Securities Administrator or other legally designated officer of the State in which the Issuer maintains its principal place of business and any State in which this notice is filed, as its agents for service of process, and agreeing that these persons may accept service on its behalf, of any notice, process or pleading, and further agreeing that such service may be made by registered or certified mail, in any Federal or state action, administrative proceeding, or arbitration brought against it in any place subject to the jurisdiction of the United States, if the action, proceeding or arbitration (a) arises out of any activity in connection with the offering of securities that is the subject of this notice, and (b) is founded, directly or indirectly, upon the provisions of: (i) the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture Act of 1939, the Investment Company Act of 1940, or the Investment Advisers Act of 1940, or any rule or regulation under any of these statutes, or (ii) the laws of the State in which the issuer maintains its principal place of business or any State in which this notice is filed.
Certifying that the Issuer is not disqualified from relying on any Regulation D exemption it has identified in Item 6 above for one of the reasons stated in Rule 505(b)(2)(iii).
Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person.
For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature.
Issuer Signature Name of Signer Title Date
BALTIA AIR LINES INC Igor Dmitrowsky Igor Dmitrowsky President and CFO 2015-10-08
