SEC Form 4 · accession 0001019687-16-006182
QS Energy, Inc. · QSEP
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Don Dickson
Director
Period of report
May 9, 2016
Accepted (ET)
May 10, 2016 · 2:46 pm EDT
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 | $0.19 | Jan 1, 2016 | A | 263,158 | A | Jan 1, 2016 | Jan 1, 2026 | Common Stock | 263,158 | 456,203 | D |
Explanation of responses
- F1The stock options reported under item 5 above were granted to each member of lssurer's Board as equity compensation under the Issuer's Board Compensation Policy, approved by the Board on June 19, 2015. The options granted under item 5 vest at the rate of 1/12 per month, commencing January 1, 2016, with full vesting on December 31, 2016.