SEC Form 4 · accession 0001140361-15-032134
LIBERTY STAR URANIUM & METALS CORP. · LBSR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Brett Gross
Director
Period of report
Aug 10, 2015
Accepted (ET)
Aug 14, 2015 · 2:54 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001172178
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Shares | Aug 10, 2015 | M | 16,806,723 | $0.0017 | A | 34,292,388 | D | |
| Common Shares | holding | — | — | — | 17,485,665 | D | ||
| Common Shares | holding | — | — | — | 910,470 | I | Held by spouse |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantsF2 | $0.0024 | Aug 10, 2015 | M | 33,613,446 | A | Aug 10, 2015 | Aug 10, 2018 | Common Shares | 33,613,446 | 39,655,742 | D |
| Promissory NoteF1 | $0.0017 | Aug 10, 2015 | D | — | D | May 29, 2015 | — | Units | 16,806,723 | 0 | D |
| Warrants | $0.0116 | holding | — | — | — | May 28, 2013 | May 28, 2016 | Common | 6,042,296 | 6,042,296 | D |
| Promissory NoteF1 | — | holding | — | — | — | May 29, 2015 | — | Units | 16,806,723 | — | D |
Explanation of responses
- F1The non-interest bearing promissory note with the principal amount of $30,000 is convertible into 16,806,723 units (each, a "Unit") at a price of $0.001785 per Unit upon the increase of the authorized capital of Liberty Star Uranium & Metals Corp. Each Unit is comprised of one common share and two warrants. Each warrant will be exercisable for a period of three years at a price of $0.002499.
- F2The warrants were acquired as part of units issued upon conversion of the non-interest bearing promissory note with the principal amount of $30,000, which was convertible into 16,806,723 units (each, a "Unit") at a price of $0.001785 per Unit. Each Unit is comprised of one common share and two warrants. Each warrant will be exercisable for a period of three years at a price of $0.002499.