SEC Form 4 · accession 0001493152-18-014383
OMNIQ Corp. · OMQS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Shai Shalom Lustgarten
Officer — Chief Executive Officer · Director · 10% Owner
Period of report
Oct 5, 2018
Accepted (ET)
Oct 11, 2018 · 5:02 pm EDT
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 | Oct 5, 2018 | J | 11,226,477 | $0.236 | A | 20,133,977 | I | See footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible Promissory NoteF3 | $0.236 | Oct 5, 2018 | J | 1,483,051 | A | Oct 11, 2018 | Oct 11, 2019 | Common stock | 1,483,051 | 1,483,051 | I |
Explanation of responses
- F1The shares were acquired by Mr. Lustgarten's company, Walefar Investments, Ltd., in the Purchase Agreement dated October 05, 2018 by and among Quest Solution, Inc., Campbeltown Consulting, Ltd. and Walefar Investments, Ltd.
- F2The shares are held by Walefar Investments, Ltd. which is beneficially owned by Mr. Lustgarten.
- F3The convertible promissory note was issued to Mr. Lustgarten's company, Walefar Investments, Ltd., in the Purchase Agreement dated October 05, 2018 by and among Quest Solution, Inc., Campbeltown Consulting, Ltd. and Walefar Investments, Ltd.