Home/Filings/5/0001493152-22-004630
5//SEC Filing

Baum Douglas R 5

Accession 0001493152-22-004630

CIK 0001310527other

Filed

Feb 14, 7:00 PM ET

Accepted

Feb 15, 6:14 AM ET

Size

15.3 KB

Accession

0001493152-22-004630

Insider Transaction Report

Form 5
Period: 2021-12-31
Baum Douglas R
DirectorCEO & Director
Transactions
  • Other

    Common Stock

    2021-12-06+10,093,80010,093,800 total
  • Award

    Options to buy common Stock

    2020-01-14+8,0008,000 total
    Exercise: $0.50Exp: 2025-01-14Common Stock (8,000 underlying)
  • Other

    Series E-1 Preferred Stock

    2021-12-062,9750 total
  • Purchase

    Series B Preferred Stock

    2021-01-22$3000.00/sh+3$9,0003 total
  • Award

    Series E-1 Preferred Stock

    2020-12-30+2,9750 total
    Exercise: $0.00Common Stock (2,975,000 underlying)
  • Award

    Options to buy common Stock

    2021-08-24+125,000125,000 total
    Exercise: $0.36Exp: 2031-08-23Common Stock (125,000 underlying)
Footnotes (4)
  • [F1]Pursuant to reclassification exempt under Rule 16b-7, each share of Series E-1 Preferred Stock was reclassified into and exchanged for shares of Common Stock of the Issuer under the terms of Exchange Agreement and Plan of Reorganization as filed with the SEC.
  • [F2]Series E-1 preferred stock was convertible at any time at the discretion of the holder at a ratio of 1000 shares of common stock per Series E-1 preferred stock.
  • [F3]The options vests annually in two equal installments beginning on 1/14/2021.
  • [F4]The option vestssemi-annually in two equal installments beginning on 02/24/2022.

Documents

1 file

Issuer

QSAM Biosciences, Inc.

CIK 0001310527

Entity typeother

Related Parties

1
  • filerCIK 0001422574

Filing Metadata

Form type
5
Filed
Feb 14, 7:00 PM ET
Accepted
Feb 15, 6:14 AM ET
Size
15.3 KB