Statement of Changes in Beneficial Ownership (4)

Date : 12/28/2018 @ 3:58PM
Source : Edgar (US Regulatory)
Stock : Coates International, Ltd. (PC) (COTE)
Quote : 0.0002  0.0 (0.00%) @ 8:45PM

Statement of Changes in Beneficial Ownership (4)

FORM 4
[ ] 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
                                                                                  
OMB APPROVAL
OMB Number: 3235-0287
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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
                      

1. Name and Address of Reporting Person *

Coates George J.
2. Issuer Name and Ticker or Trading Symbol

COATES INTERNATIONAL LTD DE [ COTE ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

__ X __ Director                      __ X __ 10% Owner
__ X __ Officer (give title below)      _____ Other (specify below)
President and CEO
(Last)          (First)          (Middle)

1811 MURRAY DRIVE
3. Date of Earliest Transaction (MM/DD/YYYY)

12/26/2018
(Street)

WALL TOWNSHIP, NJ 07719
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
6. Individual or Joint/Group Filing (Check Applicable Line)

_ X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price

Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities)
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
Series B Preferred Stock   $0.0000   12/26/2018     A      900000.0000       12/26/2020     (1) Common Stock   900000000.0000   $0.0000   4979047.0000   (2) D  
 
Series B Preferred Stock   $0.0000   12/26/2018     A      900000.0000       12/26/2020     (1) Common Stock   900000000.0000   $0.0000   5879047.0000   (2) D  
 
Series B Preferred Stock   $0.0000   12/26/2018     A      900000.0000       12/26/2020     (1) Common Stock   900000000.0000   $0.0000   6779047.0000   (2) D  
 
Series B Preferred Stock   $0.0000   12/26/2018     A      900000.0000       12/26/2020     (1) Common Stock   900000000.0000   $0.0000   7679047.0000   (2) D  
 
Series B Preferred Stock   $0.0000   12/26/2018     A      900000.0000       12/26/2020     (1) Common Stock   900000000.0000   $0.0000   8579047.0000   (2) D  
 
Series B Preferred Stock   $0.0000   12/26/2018     A      692845.0000       12/26/2020     (1) Common Stock   692845000.0000   $0.0000   9271892.0000   (2) D  
 

Explanation of Responses:
(1)  There is no expiration date.
(2)  Each share of Series B entitles the holder to 1,000 votes at any meeting where corporate matters are brought before the shareholders for a vote. The Series B is restricted, unregistered stock which is not convertible until the second annual anniversary after the date of issue, after which each share is freely convertible into 1,000 restricted, unregistered shares of common stock. In the event of a sale or change of control of the Corporation, the Series B shall become immediately convertible. The anti-dilution award of Series B Convertible Preferred Stock to Mr. Coates was determined to be the number of shares of Series B required to restore Mr. Coates' ownership percentage of outstanding common stock on a pro forma basis to 80.1%, assuming all of the Series B shares were converted into common stock.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director 10% Owner Officer Other
Coates George J.
1811 MURRAY DRIVE
WALL TOWNSHIP, NJ 07719
X X President and CEO

Signatures
/s/ George J. Coates 12/28/2018
** Signature of Reporting Person Date


Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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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