SEC Form 4 · accession 0000947871-15-000509
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
Jul 26, 2015
Accepted (ET)
Jul 28, 2015 · 8:26 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001025362
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible DebentureF4,F1,F3 | — | Jul 26, 2015 | J | 1 | D | — | Jul 26, 2015 | Common Stock | 2,427,184 | 0 | D |
Explanation of responses
- F1Lower of $1.03 CAD and the market price as of July 26, 2015 (the "Expiration Date").
- F2This report on Form 4 is being filed voluntarily to report the expiration of the conversion privilege of the convertible debenture as a result of the issuer's repayment of the principal amount of the debenture and the interest thereon. The reporting person received no value from the expiration of the conversion privilege.
- F3Exercisable from issuance on July 26, 2013 through the Expiration Date.
- F4Amounts in Canadian dollars.