SEC Form 4 · accession 0001683168-17-001951
QS Energy, Inc. · QSEP
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Gary M Buchler
Director
Period of report
Aug 2, 2017
Accepted (ET)
Aug 3, 2017 · 6:50 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001103795
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Aug 2, 2017 | C | 93,750 | $0.13 | A | 93,750 | D | |
| Common StockF1 | Aug 2, 2017 | P | 181,355 | $0.2085 | A | 275,105 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OptionsF2 | $0.13 | Aug 2, 2017 | C | 93,750 | D | May 9, 2017 | May 9, 2027 | Common Stock | 93,750 | 156,250 | D |
Explanation of responses
- F1Reporting Person purchased common stock directly from Issuer in a private transaction on 08/02/2017. Common Stock sold pursuant to this transaction was sold at the price quoted in the OTCQB market for Issuer's common stock at the close of market on the date of the transaction.
- F2Reporting Person converted stock options granted upon his appointment to Issuer's Board on 05/09/2017, as equity compensation under the Issuer's Board Compensation Policy, approved by the Board on 06/19/2015. As of 08/01/2017, a total of 93,750 of those stock options so issued had vested to Reporting Person.