QS Energy, Inc. 4
4 · QS Energy, Inc. · Filed May 17, 2017
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.