o NoneEntity Type
0001117171
China BAK Battery, Inc.
CHINA BAK BATTERY INC
MEDINA COFFEE INC
 
x Corporation
o Limited Partnership
o Limited Liability Company
o General Partnership
o Business Trust
o Other
Name of Issuer
 CBAK Energy Technology, Inc.
Jurisdiction of Incorporation/OrganizationNEVADA 
Year of Incorporation/Organization
  x Over Five Years Ago
  o Within Last Five Years (Specify Year)  
  o Yet to Be Formed 



2. Principal Place of Business and Contact Information
Name of Issuer 
 CBAK Energy Technology, Inc. 
Street Address 1Street Address 2
 CBAK INDUSTRIAL PARK, MEIGUI STREET HUAYUANKOU ECONOMIC ZONE
CityState/Province/CountryZIP/Postal CodePhone No. of Issuer
 DALIAN, LIAONING CHINA 116450 (86)(411)-3918-5985 



3. Related Persons
Last NameFirst NameMiddle Name
LiYunfei
Street Address 1Street Address 2
CBAK Industrial Park, Meigui StreetHuayuankou Economic Zone
CityState/Province/CountryZIP/Postal Code
Dalian, LiaoningCHINA116450
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
XueJ. Simon
Street Address 1Street Address 2
CBAK Industrial Park, Meigui StreetHuayuankou Economic Zone
CityState/Province/CountryZIP/Postal Code
Dalian, LiaoningCHINA116450
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
AgeeMartha
Street Address 1Street Address 2
CBAK Industrial Park, Meigui StreetHuayuankou Economic Zone
CityState/Province/CountryZIP/Postal Code
Dalian, LiaoningCHINA116450
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
HeJianjun
Street Address 1Street Address 2
CBAK Industrial Park, Meigui StreetHuayuankou Economic Zone
CityState/Province/CountryZIP/Postal Code
Dalian, LiaoningCHINA116450
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

 
Last NameFirst NameMiddle Name
WangGuosheng
Street Address 1Street Address 2
CBAK Industrial Park, Meigui StreetHuayuankou Economic Zone
CityState/Province/CountryZIP/Postal Code
Dalian, LiaoningCHINA116450
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
PeiXiangyu
Street Address 1Street Address 2
CBAK Industrial Park, Meigui StreetHuayuankou Economic Zone
CityState/Province/CountryZIP/Postal Code
Dalian, LiaoningCHINA116450
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
 

 


4. Industry Group
o Agriculture Health Care o Retailing
 Banking & Financial Services   o Biotechnology o Restaurants
  o Commercial Banking   o Health Insurance Technology
  o Insurance  o Hospitals & Physicians  o Computers
  o Investing  o Pharmaceuticals  o Telecommunications
  o Investment Banking  o Other Health Care  o Other Technology
  o Pooled Investment Fund

    Travel
  o Other Banking & Financial Services x Manufacturing  o Airlines & Airports
 Real Estate  o Lodging & Conventions
  o Commercial  o Tourism & Travel Services
  o Construction  o Other Travel
  o REITS & Finance o Other
  o Residential 
  o Other Real Estate 
o Business Services 
 Energy 
  o Coal Mining 
  o Electric Utilities 
  o Energy Conservation 
  o Environmental Services 
  o Oil & Gas 
  o Other Energy 


5. Issuer Size
Revenue RangeAggregate Net Asset Value Range
o No Revenues o No Aggregate Net Asset Value
o $1 - $1,000,000 o $1 - $5,000,000
o $1,000,001 - $5,000,000 o $5,000,001 - $25,000,000
x $5,000,001 - $25,000,000 o $25,000,001 - $50,000,000
o $25,000,001 - $100,000,000 o $50,000,001 - $100,000,000
o Over $100,000,000 o Over $100,000,000
o Decline to Disclose o Decline to Disclose
o Not Applicable o Not Applicable


6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
o Rule 504(b)(1) (not (i), (ii) or (iii)) o Rule 505
o Rule 504 (b)(1)(i) x Rule 506(b)
o Rule 504 (b)(1)(ii) o Rule 506(c)
o Rule 504 (b)(1)(iii) o Securities Act Section 4(a)(5)
  o Investment Company Act Section 3(c)

7. Type of Filing
x New Notice Date of First Sale 2021-02-08 o First Sale Yet to Occur
o Amendment

8. Duration of Offering
Does the Issuer intend this offering to last more than one year? o Yes x No

9. Type(s) of Securities Offered (select all that apply)
o Pooled Investment Fund Interests o Equity
o Tenant-in-Common Securities o Debt
o Mineral Property Securities x Option, Warrant or Other Right to Acquire Another Security
x Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security o Other (describe)
  


10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? o Yes x No
 
Clarification of Response (if Necessary) 
  

11. Minimum Investment
Minimum investment accepted from any outside investor$ 0 USD

12. Sales Compensation
RecipientRecipient CRD Number o None
 FT Global Capital, Inc. 141294
(Associated) Broker or Dealer x None(Associated) Broker or Dealer CRD Number x None
    
Street Address 1Street Address 2
 5 CONCOURSE PARKWAY SUITE 3000
City State/Province/CountryZIP/Postal Code
 ATLANTA GEORGIA 30328
State(s) of Solicitation o All States o Foreign/Non-US
 CALIFORNIA
 CONNECTICUT
 NEW JERSEY
 NEW YORK
 

 



13. Offering and Sales Amounts
Total Offering Amount $ 38398987 USD o Indefinite
Total Amount Sold $ 38398987 USD 
Total Remaining to be Sold $ 0 USD o Indefinite
 
Clarification of Response (if Necessary)
 Represents proceeds to be received by the Issuer if the issued warrants (Series A-1 warrants to purchase up to 4,469,988 shares and placement agent warrant to purchase up to 446,999 shares) are exercised for cash.


14. Investors
o Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering
 
  Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: 4


15. Sales Commissions & Finders’ Fees Expenses
Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
Sales Commissions$ 4200000 USD o Estimate
Finders' Fees$ 0 USD o Estimate
 
Clarification of Response (if Necessary)
 Represents 6% of the gross proceeds from the concurrent registered direct offering of $70.0 million. Issuer also issued placement agent warrants (as described in Item 13) to purchase up to 446,999 shares, exercisable at a price of $9.204 per share.


16. Use of Proceeds
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
 $ 0 USD o
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