SEC Form 4 · accession 0001185185-17-001401
Petrolia Energy Corp · BBLS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Leo B Womack
Director
Period of report
Jun 6, 2017
Accepted (ET)
Jun 16, 2017 · 2:49 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001368637
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Preferred Stock | May 23, 2017 | A | 5,500 | $10.00 | A | 5,500 | D | |
| Common Stock | May 26, 2017 | A | 20,000 | $0.12 | A | 25,500 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant | $0.20 | May 26, 2017 | P | 70,000 | A | Jun 6, 2017 | Jun 6, 2020 | Common Stock | 70,000 | 70,000 | D |
| Warrant | $0.12 | May 23, 2017 | P | 1,000,000 | A | May 23, 2017 | May 23, 2020 | Common Stock | 1,000,000 | 1,070,000 | D |