SEC Form 4 · accession 0001580695-18-000493

Petrolia Energy Corp · BBLS

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director

Period of report

Jul 24, 2018

Accepted (ET)

Nov 7, 2018 · 3:52 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	Jul 24, 2018	P	468,750	$0.065	A	1,885,416	I	American Resources Offshore Inc.
Common Stock	Aug 15, 2018	P	547,755	$0.064	A	2,433,171	I	American Resources Offshore Inc.

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Warrants to Purchase Common Stock^F1	$0.10	Aug 17, 2018	A	20,000	A	Aug 17, 2018	Aug 17, 2019	Common Stock	20,000	20,000	I
Convertible Promissory Note^F2,F3	$0.10	Aug 17, 2018	A	—	A	Aug 17, 2018	Oct 17, 2018	Common Stock	200,000	—	I
Options to Purchase Common Stock^F4	$0.10	Sep 30, 2018	A	250,000	A	Sep 30, 2018	Sep 30, 2020	Common Stock	250,000	250,000	D

F1As additional consideration for entering into the Convertible Promissory Note on the same date (as described in the table above), the Issuer granted the Reporting Person one-year warrants to purchase one share of the Issuer's common stock at an exercise price of $0.10 per share for each dollar loaned pursuant to the Convertible Promissory Note. Exempt pursuant to Rule 16b3(d).
F2The Convertible Promissory Note was due on October 17, 2018.
F3Not including any shares issuable upon conversion of accrued interest. The Convertible Promissory Note accrues interest at the rate of 12% per annum until paid in full, which interest is convertible into shares of common stock on the same terms as the principal amount of the debt. Exempt pursuant to Rule 16b3(d).
F4Issued in consideration for services rendered. Exempt pursuant to Rule 16b3(d).