SEC Form 4 · accession 0001140361-16-047957
OMNIQ Corp. · OMQS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Period of report
Jan 13, 2016
Accepted (ET)
Jan 15, 2016 · 7:45 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000278165
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF2 | Jan 13, 2016 | J | 650,000 | $1.00 | D | 7,350,000 | I | By Irrevocable Trust |
| Common Stock | holding | — | — | — | 897,367 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option to Purchase Common StockF3,F2 | $1.00 | Jan 13, 2016 | J | 650,000 | D | Jan 12, 2016 | Dec 31, 2016 | Common Stock | 650,000 | 0 | I |
Explanation of responses
- F1The shares were transferred by the Reporting Person in exchange for a promissory note for $1.00 per share.
- F2These shares are held in an irrevocable trust for the benefit of the Reporting Person for which the Reporting Person serves as trustee.
- F3Reporting Person has given the option to a third party for purchase of 650,000 shares at $1.00 per share expiring on December 31, 2016.