Statement of Changes in Beneficial Ownership (4)
November 29 2021 - 4:07PM
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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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
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1. Name and Address of Reporting Person
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McDonald Anthony K |
2. Issuer Name and Ticker or Trading Symbol
CEA Industries Inc.
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SRNA
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner
__X__ Officer (give title below) _____ Other (specify below)
CEO/President |
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(Last)
(First)
(Middle)
1773 E. 164TH PL |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/24/2021 |
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(Street)
BRIGHTON, CO 80602
(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 | 11/24/2021 | 11/24/2021 | J | | 1020408 | A | $.049 | 1217776 | 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 |
| Option to purchase common stock (1) | $0.049 | 11/24/2021 | 11/24/2021 | A | | 6790340 (1) | | 11/24/2021 | 11/24/2031 | Common Stock | 6790340 | (1) | 6790340 | D | |
| Explanation of Responses: |
| (1) | Represents the grant of stock options to purchase 6,790,340 shares of common stock, under the 2021 Equity Incentive Plan, at an exercise price of $0.049 per share, the price of a share of common stock on the day immediately prior to the signing of the employment agreement. The options vest at the rate of one third the total amount, on November 24, in each of the years 2021, 2022 and 2023. The grant of these options and the issuance of shares of common stock upon exercise are transactions exempt from Section 16(b) of the Exchange Act. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
McDonald Anthony K
1773 E. 164TH PL
BRIGHTON, CO 80602 | X |
| CEO/President |
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Signatures
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| /s/ Anthony K McDonald | | 11/29/2021 |
| **Signature of Reporting Person | Date |