SEC Form 4 · accession 0001019687-15-000347
QS Energy, Inc. · QSEP
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Nathan E Shelton
Director
Period of report
Jan 1, 2015
Accepted (ET)
Jan 28, 2015 · 1:05 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001103795
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option to Purchase Common StockF1 | $0.48 | Jan 1, 2015 | A | 62,500 | A | Jan 1, 2015 | Jan 1, 2025 | Common Stock | 62,500 | 402,857 | D |
| Option to Purchase Common StockF1 | $0.48 | Jan 1, 2015 | A | 52,083 | A | Jan 1, 2016 | Jan 1, 2025 | Common Stock | 52,083 | 454,940 | D |
Explanation of responses
- F1The stock options reported herein were granted to each member of Issuer's Board as equity compensation.