SEC Form 4 · accession 0001454170-18-000005
GOLDEN QUEEN MINING CO LTD · GQM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas Moragne Clay
Officer — CEO · Director
Period of report
Jun 5, 2018
Accepted (ET)
Jun 6, 2018 · 4:04 pm EDT
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 StockF1 | Jun 5, 2018 | J | 248,082 | $0.00 | D | 0 | I | By Corporation |
| Common Stock | holding | — | — | — | 6,658,116 | D | ||
| Common StockF2 | holding | — | — | — | 7,031,755 | I | By trust | |
| Common StockF3 | holding | — | — | — | 807,250 | I | By trust |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Represents shares of common stock of Golden Queen Mining Co. Ltd. (the "Issuer") held by LTC Corporation ("LTC Corp"). The Estate of Landon Thomas Clay (the "Estate") is the sole stockholder of LTC Corp following the death of Mr. Landon Thomas Clay, the Reporting Person's father, in July 2017. The Reporting Person is the executor of the Estate and the president of LTC Corp. On June 4, 2018, LTC Corp distributed all of its shares of common stock of the Issuer to the Estate. Following this disposition the Reporting Person no longer holds any beneficial interest in these shares of common stock of the Issuer.
- F2Represents shares of common stock of the Issuer held by the Monadnock Charitable Lead Annuity Trust dated May 31, 1996 ("Monadnock"). East Hill Management Company, LLC ("East Hill") provides investment advisory services to Monadnock. The Reporting Person is the sole manager of East Hill. Mr. Landon Thomas Clay was the donor of the assets to Monadnock and the Reporting Person has a remainder beneficial interest in the assets held by Monadnock. The Reporting Person disclaims beneficial ownership of the shares of common stock of the Issuer held by Monadnock except to the extent of the Reporting Person's proportionate pecuniary interest therein.
- F3Represents common shares of the Issuer held by Arctic Coast Petroleums, Ltd. ("Arctic Coast"). The Reporting Person is a trustee of the Clay Family 2009 Irrevocable Trust dated April 14, 2009 (the "2009 Trust"), which owns 50% of the equity interests of Arctic Coast. Mr. Landon Thomas Clay was the donor of the portion of Arctic Coast held by the 2009 Trust. The Reporting Person is a director of Arctic Coast. The Reporting Person disclaims beneficial ownership of 50% of the shares of Common Stock held by Arctic Coast.