|5Feb 16, 4:01 PM ET

Bolin Kevin 5

5 · QSAM Biosciences, Inc. · Filed Feb 16, 2021

Insider Transaction Report

Form 5
Period: 2020-12-31
Bolin Kevin
Director
Transactions
  • Award

    COMMON STOCK

    2020-12-17$0.22/sh+695,854$153,0881,209,490 total
  • Conversion

    COMMON STOCK

    2020-09-30$0.22/sh+113,636$25,000513,636 total
Holdings
  • Options to buy common stock

    Exercise: $0.50From: 2016-02-25Exp: 2026-02-25COMMON STOCK (88,000 underlying)
    88,000
Footnotes (2)
  • [F1]Shares acquired upon conversion of promissory note at a conversion price of $0.22 per share.
  • [F2]Shares acquired upon conversion of accured salary at a conversion price of $0.22 per share.

Documents

1 file
  • 5
    ownership.xmlPrimary