SEC Form 4 · accession 0001213900-16-016796

Workhorse Group Inc. · WKHS

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

Reporting owner

Director

Period of report

Sep 14, 2016

Accepted (ET)

Sep 14, 2016 · 5:07 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001425287

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock, $0.001 par value per share^F2	Sep 14, 2016	P	143,500	$5.28	A	714,928	I	See Footnote

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Common Stock Purchase Warrant^F3,F2	$5.28	Sep 14, 2016	X	143,500	D	Nov 9, 2015	Nov 9, 2020	Common Stock, Par Value	143,500	285,071	I
Stock Options^F4	$7.21	Aug 16, 2016	A	10,000	D	Aug 16, 2016	Aug 16, 2021	Common Stock, Par Value $0.001	—	—	D
Stock Options^F1	$7.01	holding	—	—	—	Dec 17, 2015	Dec 17, 2020	Common Stock, Par Value $0.001	50,000	50,000	D
Common Stock Purchase Warrant^F3,F2	$5.28	holding	—	—	—	Dec 4, 2015	Dec 4, 2020	Common Stock, Par Value $0.001	142,857	142,857	I

F110,000 of the options vested on December 17, 2015 and 4,000 shall vest every six (6) months thereafter.
F2On November 9, 2015, Samuels 2012 Children's Trust UAD 10/28/12 (the "Trust") acquired a Stock Purchase Warrant to acquire 428,571 shares of common stock (the "Initial Warrant"). On December 4, 2015, the Trust acquired a Stock Purchase Warrant to acquire 142,857 shares of common stock. On January 5, 2016, convertible notes held by the Trust were automatically converted into 571,429 shares of common stock. Further, on September 14, 2016, the Trust exercised the Initial Warrant and received 143,500 shares of common stock for a purchase price of $757,680 or $5.28 per share.
F3H. Benjamin Samuels is a trustee and beneficiary of the Trust
F42,500 of the options vested on August 16, 2016 and an additional 2,500 will vest every six months thereafter.