Statement of Changes in Beneficial Ownership (4)
July 16 2021 - 3:27PM
Edgar (US Regulatory)
FORM 4
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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).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
*
CLAYBORNE JEFF |
2. Issuer Name and Ticker or Trading Symbol
Verb Technology Company, Inc.
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VERB
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) CFO |
(Last)
(First)
(Middle)
782 S. AUTO MALL DRIVE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
7/14/2021 |
(Street)
AMERICAN FORK, UT 84003
(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)
_X
_ Form filed by One Reporting Person
___ 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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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 7/14/2021 | | M | | 100000 | A | $1.65 | 1155672 | D | |
Common Stock | 7/14/2021 | | F | | 66265 (1) | D | $2.49 | 1089407 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Common Stock | $1.65 | 7/14/2021 | | M | | | 100000 | 7/15/2016 | 7/14/2021 | Common Stock | 100000 | $0 | 0 | D | |
Explanation of Responses: |
(1) | Shares withheld to pay exercise price on cashless option exercise. |
Remarks: The transactions described herein reflect the net exercise of stock options in accordance with the terms of the applicable stock option agreement. No shares were sold in connection with the exercise of the stock options. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
CLAYBORNE JEFF 782 S. AUTO MALL DRIVE AMERICAN FORK, UT 84003 |
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| CFO |
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Signatures
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/s/ Jeff Clayborne | | 7/16/2021 |
**Signature of Reporting Person | Date |
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