SEC Form 3/A · accession 0001052918-17-000075
Jayhawk Energy, Inc. · JYHW
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 3/A). It replaces an earlier filing for the same period.
Reporting owner
Shawn B Smart
10% Owner
Period of report
Sep 20, 2016
Accepted (ET)
Jan 27, 2017 · 3:24 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001308710
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common stockF1 | holding | — | — | — | 39,583,263 | I | By Smart Oil, LLC |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible Promissory NoteF1 | $0.0065 | holding | — | — | — | Sep 20, 2016 | Sep 19, 2018 | Common stock | 1,000,000 | — | I |
| Stock Purchase WarrantF1 | $0.005 | holding | — | — | — | Oct 8, 2015 | Oct 7, 2020 | Common stock | 23,583,418 | — | I |
Explanation of responses
- F1This Amendment clarifies the number of Common Shares beneficially owned by Mr. Shawn Smart. Mr. Shawn Smart is the Managing Member of Smart Oil, LLC, and therefore is deemed to be a Beneficial Owner of Smart Oil, LLC's ownership interests in JayHawk Energy, Inc. by virtue of the voting and dispositive control Mr. Smart has over Smart Oil, LLC. Mr. Smart disclaims any Beneficial Ownership in the JayHawk Energy, Inc. interests.
Remarks
No securities are beneficially owned by the Person signing on behalf of the Reporting Person.