SEC Form 4 · accession 0001213900-16-019597
BioSolar Inc · NEWH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David Donghie Lee
Officer — CEO, Acting CFO · Director · 10% Owner
Period of report
Dec 19, 2016
Accepted (ET)
Dec 21, 2016 · 5:00 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001371128
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Dec 19, 2016 | J | 1,316,235 | — | A | 4,769,290 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible NoteF1 | — | Dec 19, 2016 | J | 1,316,235 | D | Dec 18, 2014 | Dec 18, 2016 | Common Stock | 1,316,235 | 0 | D |
Explanation of responses
- F1Common Stock was issued to Reporting Person upon the conversion of a convertible promissory note (the "Promissory Note") granted to the Reporting Person by the Issuer pursuant to a Convertible Note Agreement dated December 18, 2014, which was issued directly to Reporting Person by the Issuer in satisfaction of unpaid salary. The balance of the Promissory Note was convertible into shares of the Issuer's common stock at a conversion price equal to the lesser of (i) $0.101 per share, or (ii) the closing prices of the Issuer's common stock on the last complete trading day immediately preceding the date of conversion. The original balance of the Promissory Note was $67,000. There is no longer a balance on this Promissory Note.