|4Aug 8, 4:51 PM ET

QS Energy, Inc. 4

4 · QS Energy, Inc. · Filed Aug 8, 2016

Insider Transaction Report

Form 4
Period: 2016-08-05
Dickson Don
Director
Transactions
  • Award

    Convertible Note

    2016-08-05$70000.00/sh+70,000$4,900,000,0001,226,203 total
    Exercise: $0.10From: 2016-08-05Common Stock (770,000 underlying)
  • Award

    Warrants

    2016-08-05+385,0001,611,203 total
    Exercise: $0.10From: 2016-08-05Exp: 2017-08-04Common Stock (385,000 underlying)
Footnotes (3)
  • [F1]Reporting Person acquired Issuer's Convertible Note in the principal amount of $77,000, for a purchase price of $70,000, convertible into 770,000 shares of common stock of Issuer.
  • [F2]Not applicable.
  • [F3]Reporting Person acquired Issuer's Warrants as part of Reporting Person's purchase of Issuer's Convertible Note reported above.

Documents

1 file
  • 4
    dickson_frm4.xmlPrimary

    FORM 4