4//SEC Filing
QS Energy, Inc. 4
Accession 0001683168-17-001326
$QSEPCIK 0001103795operating
Filed
May 16, 8:00 PM ET
Accepted
May 17, 4:54 PM ET
Size
13.3 KB
Accession
0001683168-17-001326
Insider Transaction Report
Form 4
QS Energy, Inc.QSEP
Munn Richard William
Director
Transactions
- Purchase
Common Stock
2017-05-15$0.24/sh+42,000$10,080→ 42,000 total - Conversion
Common Stock
2017-05-15$0.05/sh+220,000$11,000→ 262,000 total - Award
Convertible Note
2017-05-15$10000.00/sh→ 470,000 totalExercise: $0.05From: 2017-05-15→ Common Stock (220,000 underlying) - Award
Warrants
2017-05-15+110,000→ 580,000 totalExercise: $0.05From: 2017-05-15Exp: 2018-05-15→ Common Stock (110,000 underlying) - Disposition to Issuer
Convertible Note
2017-05-15$11000.00/sh→ 360,000 totalExercise: $0.05→ Common Stock (220,000 underlying)
Footnotes (4)
- [F1]Reporting Person acquired Issuer's Convertible Note in the principal amount of $11,000, for a purchase price of $10,000, convertible into 220,000 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.
- [F4]Reporting Person converted the Convertible Note listed above and described in Footnote 1 of this Form 4.
Documents
Issuer
QS Energy, Inc.
CIK 0001103795
Entity typeoperating
IncorporatedNV
Related Parties
1- filerCIK 0001103795
Filing Metadata
- Form type
- 4
- Filed
- May 16, 8:00 PM ET
- Accepted
- May 17, 4:54 PM ET
- Size
- 13.3 KB