SEC Form 4 · accession 0001185185-17-002413
Petrolia Energy Corp · BBLS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James Edward Burns
Officer — President · Director
Period of report
Nov 9, 2017
Accepted (ET)
Nov 16, 2017 · 4:08 pm EST
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 |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Nov 8, 2017 | A | 350,000 | $0.12 | A | 1,800,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrants | $0.14 | Nov 8, 2017 | P | 250,000 | A | Sep 30, 2017 | Sep 30, 2020 | Common | 250,000 | 470,000 | D |
| Warrants | $0.14 | Nov 8, 2017 | P | 166,667 | A | Sep 30, 2017 | Sep 30, 2020 | Common | 166,667 | 636,667 | D |