SEC Form 4 · accession 0001209191-16-153968
Smart Sand, Inc. · SND
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert Kiszka
Officer — Executive VP of Operations
Period of report
Dec 7, 2016
Accepted (ET)
Dec 7, 2016 · 5:42 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001529628
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| COMMON STOCKF1 | Dec 7, 2016 | X | 200,000 | $0.0045 | A | 568,876 | I | BY LLC |
| COMMON STOCK | holding | — | — | — | 84,211 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMON STOCK WARRANT (RIGHT TO BUY)F1,F2 | $0.0045 | Dec 7, 2016 | X | 200,000 | D | — | Sep 13, 2019 | COMMON STOCK | 200,000 | 0 | I |
Explanation of responses
- F1Held by a limited liability company ("LLC") of which the Reporting Person serves as the sole member with sole voting and investment control over the securities held thereby. The Reporting Person disclaims beneficial ownership of the securities held by the LLC except to the extent of his pecuniary interest therein.
- F2The warrant is exercisable on or after the date immediately following the 20th consecutive trading day on which the Issuer's common stock is actively traded on a national securities exchange and the aggregate market value of the common stock is at least $300 million for each of the 20 trading days.