Home/Filings/4/0001683168-19-000478
4//SEC Filing

Lane Jason B 4

Accession 0001683168-19-000478

CIK 0001103795other

Filed

Feb 20, 7:00 PM ET

Accepted

Feb 21, 5:45 PM ET

Size

7.8 KB

Accession

0001683168-19-000478

Insider Transaction Report

Form 4
Period: 2019-02-21
Lane Jason B
DirectorChief Executive Officer
Transactions
  • Award

    Convertible Note

    2019-02-21$25000.00/sh4,362,492 total
    Exercise: $0.05From: 2019-02-21Common Stock (550,000 underlying)
  • Award

    Warrants

    2019-02-21+275,0004,637,492 total
    Exercise: $0.05From: 2019-02-21Exp: 2020-02-21Common Stock (275,000 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 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

1 file

Issuer

QS Energy, Inc.

CIK 0001103795

Entity typeother

Related Parties

1
  • filerCIK 0001703180

Filing Metadata

Form type
4
Filed
Feb 20, 7:00 PM ET
Accepted
Feb 21, 5:45 PM ET
Size
7.8 KB