Annual Statement of Changes in Beneficial Ownership (5)
March 31 2017 - 11:01AM
Edgar (US Regulatory)
FORM 5
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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Form 3 Holdings Reported
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Form 4 Transactions Reported
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0362
Estimated average burden
hours per response...
1.0
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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Cathaya Capital LP
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2. Issuer Name
and
Ticker or Trading Symbol
ZAP [ZAAP]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
__
X
__ 10% Owner
_____ Officer (give title below)
__
X
__ Other (specify below)
Member of 10% Group
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(Last)
(First)
(Middle)
1501-08 MILLENNIUM CITY 5, 418 KWUN TONG ROAD
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3. Statement for Issuer's Fiscal Year Ended
(MM/DD/YYYY)
12/31/2016
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(Street)
KWUN TONG, K3 418
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form Filed by One Reporting Person
_
X
_ Form Filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
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7. Nature of Indirect Beneficial Ownership
(Instr. 4)
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Amount
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(A) or (D)
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Price
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Common Stock
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7/28/2016
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7/28/2016
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P5
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8872602
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A
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$0.05
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178502878
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I
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See Footnote
(1)
(2)
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Common Stock
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7/27/2016
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7/27/2016
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P5
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18399316
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A
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$0.067
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178059248
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I
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See Footnote
(1)
(2)
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year
(Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
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11. Nature of Indirect Beneficial Ownership
(Instr. 4)
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Explanation of Responses:
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(
1)
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The shares were issued in lieu of cash payment of accrued interest on the Issuer's Senior Convertible Note held by China Electric Vehicle Corporation and on indebtedness owed by the Issuer to Cathaya Management Co. Limited. Each of China Electric Vehicle Corporation and Cathaya Management Co. Limited are affiliates of the Reporting Person.
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(
2)
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Priscilla M. Lu disclaims beneficial ownership of the Issuer's securities reported herein except to the extent of her pecuniary interest.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Cathaya Capital LP
1501-08 MILLENNIUM CITY 5
418 KWUN TONG ROAD
KWUN TONG, K3 418
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X
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Member of 10% Group
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LU PRISCILLA M
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X
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X
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Member of 10% Owner Group
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China Electric Vehicle Corp
1501-08 MILLENNIUM CITY 5
418 KWUN TONG ROAD
KWUN TONG, K3 418
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X
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Member of 10% Owner Group
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Better World International Ltd
1501-08 MILLENNIUM CITY 5
418 KWUN TONG ROAD
KWUN TONG, K3 418
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X
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Member of 10% Owner Group
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Signatures
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/s/ Priscilla M. Lu, General Partner of Cathaya Capital L. P.
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3/30/2017
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**
Signature of Reporting Person
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Date
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/s/ Priscilla M. Lu
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3/30/2017
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**
Signature of Reporting Person
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Date
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/s/ Priscilla M. Lu, director of China Electric Vehicle Corporation
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3/30/2017
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**
Signature of Reporting Person
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Date
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By: /s/ Priscilla M. Lu, director of Better World International Ltd.
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3/30/2017
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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