SEC Form 3 · accession 0001665888-16-000001
TOMI Environmental Solutions, Inc. · TOMZ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Dr. Halden Stuart Shane
Officer — Chief Executive Officer · Director · 10% Owner
Period of report
Feb 1, 2016
Accepted (ET)
Feb 4, 2016 · 4:50 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000314227
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | holding | — | — | — | 18,770,048 | D | ||
| Class A Preferred Stock | holding | — | — | — | 510,000 | 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 Purchase Warrants | $0.15 | holding | — | — | — | Oct 15, 2012 | Oct 15, 2017 | Common Stock | 3,500,000 | — | D |
| Common Stock Purchase WarrantsF2 | $0.30 | holding | — | — | — | Feb 11, 2014 | Feb 11, 2021 | Common Stock | 3,000,000 | — | D |
Explanation of responses
- F1Includes 500,000 shares owned by the Shane Family Trust of which Dr. Shane is a trustee. Does not include 1,000,000 shares held by Belinha Shane, his wife, of which he disclaims beneficial ownership.
- F22,000,000 Common Stock Purchase Warrants are currently vested and the balance of 1,000,000 Common Stock Purchase Warrants vest on 2/11/16.