SEC Form 4 · accession 0001664260-17-000001
GOLDEN QUEEN MINING CO LTD · GQM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Landon T. Clay 2016-2 Annuity Trust
10% Owner
Period of report
Jan 24, 2017
Accepted (ET)
Jan 26, 2017 · 9:54 am 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 StockF2 | Jan 24, 2017 | J | 6,884,444 | $0.7915 | D | 10,163,295 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1On January 24, 2017, Thomas M. Clay, the sole trustee of the Landon T. Clay 2016-2 Annuity Trust u/a dated January 14, 2016 (the "2016-2 GRAT"), authorized the transfer of 6,884,444 shares of common stock of Golden Queen Mining Co. Ltd. (the "Issuer") from the 2016-2 GRAT to Landon T. Clay in satisfaction of the annuity payment required by the terms of the 2016-2 GRAT. Landon T. Clay is Thomas M. Clay's father. Thomas M. Clay is the chief executive officer and a director of the Issuer.
- F2The price in Column 4 has been determined in accordance with the terms of the 2016-2 GRAT and is based on the average trading price of the Issuer's shares of common stock converted to U.S. dollars at the prevailing conversion rate on the date that was one day prior to the date of the transaction.