4//SEC Filing
Dickson Don 4
Accession 0001683168-18-003579
CIK 0001103795other
Filed
Nov 27, 7:00 PM ET
Accepted
Nov 28, 6:06 PM ET
Size
7.8 KB
Accession
0001683168-18-003579
Insider Transaction Report
Form 4
QS Energy, Inc.QSEP
Dickson Don
Director
Transactions
- Award
Warrants
2018-11-26+275,000→ 2,836,759 totalExercise: $0.05From: 2018-11-26Exp: 2019-11-26→ Common Stock (275,000 underlying) - Award
Convertible Note
2018-11-26$25000.00/sh→ 2,561,759 totalExercise: $0.05From: 2018-11-26→ Common Stock (550,000 underlying)
Footnotes (3)
- [F1]Reporting Person acquired Issuer's Convertible Note in the principal amount of $27,500, for a purchase price of $25,000, convertible into 550,000 shares of common stock of the 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.
Documents
Issuer
QS Energy, Inc.
CIK 0001103795
Entity typeother
Related Parties
1- filerCIK 0001584260
Filing Metadata
- Form type
- 4
- Filed
- Nov 27, 7:00 PM ET
- Accepted
- Nov 28, 6:06 PM ET
- Size
- 7.8 KB