SEC Form 4 · accession 0001743393-19-000001
IIOT-OXYS, Inc. · ITOX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Clifford L Emmons
Officer — CEO, President, Interim CFO · Director
Period of report
Jan 22, 2019
Accepted (ET)
Jan 24, 2019 · 1:53 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001290658
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 5% Secured Convertible NoteF1 | $0.65 | Jan 22, 2019 | P | 84,615 | A | Jan 22, 2019 | Jan 22, 2020 | Common Stock | 84,615 | 84,615 | I |
| WarrantsF2 | $0.75 | Jan 22, 2019 | P | 36,667 | A | Jan 22, 2019 | Jan 22, 2024 | Common Stock | 36,667 | 88,282 | I |
Explanation of responses
- F15% Secured Convertible Note and warrants issued to Cambridge MedSpace, LLC, of which Mr. Emmons is an owner.
- F25% Secured Convertible Note and warrants issued to Cambridge Medspace, LLC, of which Mr. Emmons is an owner.