SEC Form 4 · accession 0001683168-17-002548
QS Energy, Inc. · QSEP
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Eric Bunting
Director
Period of report
Sep 29, 2017
Accepted (ET)
Oct 2, 2017 · 7:14 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 | Sep 29, 2017 | C | 178,002 | $0.07 | A | 6,610,430 | D | |
| Common Stock | Sep 29, 2017 | P | 125,000 | $0.271 | A | 6,735,430 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OptionsF1 | $0.07 | Sep 29, 2017 | C | 178,002 | D | Apr 1, 2017 | Apr 1, 2027 | Common Stock | 178,002 | 1,279,710 | D |
Explanation of responses
- F1On 4/1/2017, the Company issued Reporting Person 535,714 options to purchase common stock as equity compensation under the Issuer's Board Compensation Policy, approved by the Board on 06/19/2015. On 9/29/2017, Reporting Person converted 178,002 of those options that had vested.