SEC Form 4 · accession 0000947871-15-000054
GOLDEN QUEEN MINING CO LTD · GQM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jonathan C. Clay
10% Owner
Period of report
Jan 21, 2015
Accepted (ET)
Jan 23, 2015 · 2:09 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001025362
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| COMMON STOCK | Jan 21, 2015 | J | 7,258,330 | $0.00 | A | 7,258,330 | I | By family investment vehicle |
| COMMON STOCK | holding | — | — | — | 1,081,686 | D | ||
| COMMON STOCKF2 | holding | — | — | — | 50,000 | I | See Footnote | |
| COMMON STOCKF3 | holding | — | — | — | 807,250 | I | See Footnote | |
| COMMON STOCKF4 | holding | — | — | — | 32,000 | I | See Footnote |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Transfer of shares to a family investment vehicle of which the Reporting Person is the manager. The transfer did not involve the payment or receipt of any cash consideration by the Reporting Person. The Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
- F2Owned by 933 Milledge LLC ("Milledge"). Mr. Clay owns 100% of Milledge.
- F3Owned by Arctic Coast Petroleums Ltd., of which Mr. Clay is 2.5% owner and Milledge is 47.5% owner. Mr. Clay disclaims beneficial ownership of the remaining 50% of the shares.
- F4Held in custody account for James Clay, Mr. Clay's son. Mr. Clay's wife Whitney is the sole custodian of such account, and Mr. Clay disclaims beneficial ownership of the shares therein.