Cecil Bond Kyte - Jun 7, 2021 Form 4 Insider Report for QS Energy, Inc. (QSEP)

Role
CEO, CFO, Director
Signature
/s/ Cecil Bond Kyte
Stock symbol
QSEP
Transactions as of
Jun 7, 2021
Transactions value $
$200,000
Form type
4
Date filed
7/28/2021, 03:47 PM
Previous filing
Jul 28, 2021

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction QSEP Common Stock Award $83K +5.53M +110.67% $0.02 10.5M Jun 7, 2021 Direct

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction QSEP Convertible Note Award $117K 6.44M Jun 7, 2021 Common Stock 6.44M $0.02 Direct F1, F2
transaction QSEP Warrants Award +3.22M +50% 9.65M Jun 7, 2021 Common Stock 3.22M $0.03 Direct F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Reporting Person acquired Issuer's Convertible Note in the principal amount of $128,700, for a purchase price of $117,000, convertible into 6,435,000 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.