SEC Form 4 · accession 0001683168-18-000498
QS Energy, Inc. · QSEP
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas A. Bundros
Director
Period of report
Jan 1, 2018
Accepted (ET)
Feb 23, 2018 · 2:43 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OptionsF1 | $0.18 | Jan 1, 2018 | A | 277,778 | A | Jan 31, 2018 | Jan 1, 2028 | Common Stock | 277,778 | 3,022,347 | D |
| OptionsF2 | $0.18 | Jan 1, 2018 | A | 138,889 | A | Jan 31, 2018 | Jan 1, 2028 | Common Stock | 138,889 | 3,161,236 | D |
Explanation of responses
- F1The stock options reported under item 1 above were granted to Reporting Person as equity compensation for service as a Director under Issuer's Board Compensation Policy, approved by the Board on 6/19/2015. The options vest at the rate of 1/12 per month, commencing 1/1/2018, with full vesting on 12/31/2018.
- F2The stock options reported under item 1 above were granted to Reporting Person as equity compensation for service as Chairman of the Audit Committee of the Board under Issuer's Board Compensation Policy, approved by the Board on 6/19/2015. The options vest at the rate of 1/12 per month, commencing 1/1/2018, with full vesting on 12/31/2018.