SEC Form 4 · accession 0001580695-18-000475
Petrolia Energy Corp · BBLS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Leo B Womack
Director
Period of report
Mar 31, 2018
Accepted (ET)
Oct 30, 2018 · 5:20 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 |
|---|---|---|---|---|---|---|---|---|
| Common Stock (Restricted)F1 | Sep 23, 2018 | M | 1,000,000 | $0.06 | A | 3,860,270 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantF2 | $0.10 | Mar 31, 2018 | A | 250,000 | A | Jan 1, 2019 | Jan 1, 2021 | Common Stock (Restricted) | 250,000 | 4,160,000 | D |
| WarrantF2 | $0.10 | Jun 30, 2018 | A | 250,000 | A | Jan 1, 2019 | Jan 1, 2021 | Common Stock (Restricted) | 250,000 | 4,410,000 | D |
| WarrantF3 | $0.10 | Aug 22, 2018 | A | 60,000 | A | Aug 22, 2018 | Aug 22, 2019 | Common Stock (Restricted) | 60,000 | 4,170,000 | D |
| WarrantF1 | $0.06 | Sep 23, 2018 | M | 1,000,000 | D | Jun 6, 2017 | Jun 6, 2020 | Common Stock (Restricted) | 1,000,000 | 3,170,000 | D |
| WarrantF2 | $0.10 | Sep 30, 2018 | A | 250,000 | A | Jan 1, 2019 | Jan 1, 2021 | Common Stock (Restricted) | 250,000 | 3,420,000 | D |
Explanation of responses
- F1Mr. Womack exercised 1,000,000 warrants that were issued on Sept. 23, 2015 and were due to expire on Sept. 23, 2018 at a predetermined share price of $0.06/share.
- F2Mr. Womack receives a 250,000-warrant issuance quarterly as part of his compensation 2018 compensation package for his service on the Board; exercisable for a 24 months period as of January 1, 2019.
- F3Mr. Womack was issued 60,000 warrants at $0.10 per share for participating in a board approved short-term loan.