Home/Filings/5/0001104659-21-024608
5//SEC Filing

Roberts Paul Damian 5

Accession 0001104659-21-024608

CIK 0001729750other

Filed

Feb 15, 7:00 PM ET

Accepted

Feb 16, 9:52 PM ET

Size

10.4 KB

Accession

0001104659-21-024608

Insider Transaction Report

Form 5
Period: 2020-12-31
Roberts Paul Damian
DirectorSee Remarks
Transactions
  • Conversion

    Common Stock Purchase Warrant

    2020-08-14+55,54155,541 total
    Exercise: $5.50From: 2020-08-14Exp: 2025-08-14Common Stock (55,541 underlying)
  • Award

    Common Stock

    2020-11-20+12,6582,123,731 total
  • Conversion

    Common Stock

    2020-08-14+55,5412,111,073 total
Footnotes (4)
  • [F1]Represents the shares of common stock of Kubient, Inc. (the "Company") issued upon conversion of $277,705 of promissory notes that, upon the initial public offering of the Company, converted into 55,541 immediately-separable units composed of (i) one share of common stock, and (ii) one warrant to purchase one share of common stock at a price of $5.50 per share.
  • [F2]Not previously reported on Form 4.
  • [F3]Includes 666,667 shares of common stock held by the Paul Roberts 2019 Annuity Trust, of which the Reporting Person is a partial beneficiary. The Reporting Person's spouse is trustee of the trust. The Reporting Person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. Also includes 55,541 shares of common stock issuable upon exercise of five-year warrants at an exercise price of $5.50 per share. Does not include 29,859 shares of common stock underlying stock options exercisable within 60 days. Also does not include 55,541 shares of common stock underlying five-year warrants issued on August 14, 2020, which are reported on Table II of this Form 5.
  • [F4]Represents the warrants to purchase shares of common stock issued upon conversion of $277,705 of promissory notes that, upon the initial public offering of the Company, converted into 55,541 immediately-separable units composed of (i) one share of common stock, and (ii) one warrant to purchase one share of common stock at a price of $5.50 per share.

Issuer

Kubient, Inc.

CIK 0001729750

Entity typeother

Related Parties

1
  • filerCIK 0001798701

Filing Metadata

Form type
5
Filed
Feb 15, 7:00 PM ET
Accepted
Feb 16, 9:52 PM ET
Size
10.4 KB