SEC Form 4 · accession 0001580695-18-000104
Petrolia Energy Corp · BBLS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Zel C Khan
Officer — CEO · Director
Period of report
Sep 30, 2016
Accepted (ET)
Feb 14, 2018 · 9:03 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 (Restricted)F1 | Dec 31, 2016 | J | 14,443,936 | $0.18 | A | 26,930,741 | I | Jovian Petroleum Corporation |
| Common Stock (Restricted)F2 | Dec 31, 2016 | J | 66,395 | $0.18 | A | 26,997,136 | I | Jovian Petroleum Corporation |
| Common Stock (Restricted)F3 | May 30, 2017 | J | 7,192,026 | $0.21 | A | 34,189,162 | I | Jovian Petroleum Corporation |
| Common Stock (Restricted)F4 | Jun 5, 2017 | A | 40,000 | $0.08 | A | 34,229,162 | I | Jovian Petroleum Corporation |
| Common Stock (Restricted)F5 | Jul 21, 2017 | J | 8,737,891 | $0.14 | A | 42,967,053 | I | Jovian Petroleum Corporation |
| Preferred Stock (Series A)F6 | Jul 24, 2017 | A | 21,510 | $10.00 | A | 21,510 | I | Jovian Petroleum Corporation |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantF4 | $0.20 | Sep 30, 2016 | P | 40,000 | A | Sep 30, 2016 | Sep 30, 2019 | Common Stock | 40,000 | 1,070,000 | D |
| WarrantF4 | $0.14 | Dec 30, 2016 | P | 40,000 | A | Mar 31, 2016 | Mar 31, 2019 | Common Stock | 40,000 | 1,110,000 | D |
| WarrantsF5 | $0.20 | May 23, 2017 | P | 6,000,000 | A | May 23, 2017 | May 23, 2020 | Common Stock | 6,000,000 | 7,110,000 | I |
| WarrantsF5 | $0.35 | May 23, 2017 | P | 4,000,000 | A | Feb 1, 2016 | Feb 1, 2019 | Common Stock | 4,000,000 | 11,110,000 | I |
Explanation of responses
- F1The 14,443,936 common shares were issued is in relation to the Share Exchange agreement were Petrolia acquired a 40% net WI from Jovian in the SUDS Field. Petrolia already owned 10% WI. Mr. Khan is the indirect beneficial owner of Jovian Petroleum Corporation; do to his majority stake in that company.
- F2This transaction of 66,395 common shares are post-closing adjustments the final distribution of shares in the acquisition of the 40% WI mentioned in the above note.
- F3This transaction is part of a debt/equity swap of which Jovian agreed to convert the outstanding $2 million note into equity in BBLS.
- F4Mr. Khan was issued Shares and Warrants as part of the deferred salary compensation he has received.
- F5This share and warrant transaction was for the conversion of debt associated to the Notes held against Petrolia, by Jovian, for the production payment debt.
- F6Jovian Petroleum Corporation participated in the Series A, Preferred Stock offering was used as part of the settlement of the $2 million Promissory note conversion.