Amended Statement of Changes in Beneficial Ownership (4/a)

Date : 11/28/2018 @ 11:07PM
Source : Edgar (US Regulatory)
Stock : Qs Energy, Inc. (QB) (QSEP)
Quote : 0.13  -0.015 (-10.34%) @ 5:27PM

Amended Statement of Changes in Beneficial Ownership (4/a)

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
                                                                                  
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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 *

Bunting Eric
2. Issuer Name and Ticker or Trading Symbol

QS Energy, Inc. [ QSEP ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

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

23902 FM 2978
3. Date of Earliest Transaction (MM/DD/YYYY)

3/30/2018
(Street)

TOMBALL, TX 77375
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

4/4/2018 
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
Common Stock   4/2/2018   4/2/2018   C    275000   A $0.08   9389530   (4) D    

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
Warrants   $0.08   3/30/2018   3/30/2018   A      275000       3/30/2018   3/30/2019   Common Stock   275000     (1) 602778   (4) D    
Warrants   $0.08   4/2/2018   4/2/2018   C         275000    4/2/2018     (2) Common Stock   275000     (3) 552778   (4) D    

Explanation of Responses:
(1)  On 3/30/2018, Reporting Person acquired 275,000 Warrants as part of Reporting Person's acquisition of Issuer's Convertible note on that same date. In Reporting Person's 04/04/2018 Form 4 reporting this acquisition, the number of Warrants acquired by Reporting Person was incorrectly stated as 225,000, a shortfall of 50,000 Warrants.
(2)  Not Applicable.
(3)  On 3/30/2018, Reporting Person converted 275,000 of Issuer's Warrants as part of Reporting Person's purchase of Issuer's Convertible Note reported above. In Reporting Person's 04/04/2018 Form 4 reporting this acquisition, the number of Warrants converted into Issuer's Common Stock was incorrectly stated as 225,000, a shortfall of 50,000 Warrants.
(4)  Amount at the time of filing of this Form 4

Reporting Owners
Reporting Owner Name / Address
Relationships
Director 10% Owner Officer Other
Bunting Eric
23902 FM 2978
TOMBALL, TX 77375
X



Signatures
/s/ Eric Bunting 11/28/2018
** 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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