Statement of Changes in Beneficial Ownership (4)
July 27 2018 - 7:18PM
Edgar (US Regulatory)
FORM 4
[
X
]
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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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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
*
Schultz Blair Albert
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2. Issuer Name
and
Ticker or Trading Symbol
Klondex Mines Unlimited Liability Co
[
KLDX
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
C/O KLONDEX MINES LTD., 6110 PLUMAS STREET, SUITE A
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3. Date of Earliest Transaction
(MM/DD/YYYY)
7/20/2018
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(Street)
RENO, NV 89519
(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 Shares
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7/20/2018
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D
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113333
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D
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(1)
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0
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D
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Common Shares
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7/20/2018
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D
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375000
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D
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(2)
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0
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I
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Blair Schultz Investco Inc.
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Common Shares
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7/20/2018
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D
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75000
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D
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(3)
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0
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I
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Schultz Family Trust
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Common Shares
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7/20/2018
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D
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1000
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D
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(4)
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0
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I
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RESP
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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)
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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
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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 Following Reported Transaction(s) (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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Code
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V
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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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Deferred Share Units ("DSUs")
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(5)
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7/20/2018
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D
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45046
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(5)
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(5)
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Common Shares
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45046
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(5)
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0
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D
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Explanation of Responses:
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(1)
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The common shares were disposed of upon completion of a statutory plan of arrangement under the Business Corporations Act (British Columbia) (the "Arrangement") and pursuant to an arrangement agreement dated March 16, 2018, by and among the Issuer, Hecla Mining Company ("Hecla") and 1156291 B.C. Unlimited Liability Company, a wholly-owned subsidiary of Hecla, in exchange for $95,324.39 in cash, 46,874 common shares of Hecla, having a market value of $3.220 per share on the effective date of the Arrangement (the "Effective Date"), and 14,166 common shares of Havilah Mining Corporation, a subsidiary of Hecla ("Havilah"), having a market value of $0.46 per share on the first date of trading.
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(2)
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The common shares were disposed of pursuant to the Arrangement in exchange for $315,412.50 in cash, 155,100 common shares of Hecla, having a market value of $3.220 per share on the Effective Date, and 46,875 common shares of Havilah, having a market value of $0.46 per share on the first date of trading.
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(3)
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The common shares were disposed of pursuant to the Arrangement in exchange for $63,082.50 in cash, 31,020 common shares of Hecla, having a market value of $3.220 per share on the Effective Date, and 9,375 common shares of Havilah, having a market value of $0.46 per share on the first date of trading.
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(4)
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The common shares were disposed of pursuant to the Arrangement in exchange for $841.10 in cash, 413 common shares of Hecla, having a market value of $3.220 per share on the Effective Date, and 125 common shares of Havilah, having a market value of $0.46 per share on the first date of trading.
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(5)
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Each DSU represented a contingent right to receive the economic equivalent of one common share of the Issuer, payable in cash. The DSUs were cancelled pursuant to the Arrangement in exchange for a cash payment of $2.36 per DSU.
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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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Schultz Blair Albert
C/O KLONDEX MINES LTD.
6110 PLUMAS STREET, SUITE A
RENO, NV 89519
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X
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Signatures
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/s/ Blair Albert Schultz
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7/27/2018
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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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