o None
Entity 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/Organization
NEVADA
 
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 1 Street Address 2
 CBAK INDUSTRIAL PARK, MEIGUI STREET  HUAYUANKOU ECONOMIC ZONE
City State/Province/Country ZIP/Postal Code Phone No. of Issuer
 DALIAN, LIAONING  CHINA  116450  (86)(411)-3918-5985 



3. Related Persons
Last Name First Name Middle Name
Li Yunfei
Street Address 1 Street Address 2
CBAK Industrial Park, Meigui Street Huayuankou Economic Zone
City State/Province/Country ZIP/Postal Code
Dalian, Liaoning CHINA 116450
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last Name First Name Middle Name
Xue J. Simon
Street Address 1 Street Address 2
CBAK Industrial Park, Meigui Street Huayuankou Economic Zone
City State/Province/Country ZIP/Postal Code
Dalian, Liaoning CHINA 116450
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last Name First Name Middle Name
Agee Martha
Street Address 1 Street Address 2
CBAK Industrial Park, Meigui Street Huayuankou Economic Zone
City State/Province/Country ZIP/Postal Code
Dalian, Liaoning CHINA 116450
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last Name First Name Middle Name
He Jianjun
Street Address 1 Street Address 2
CBAK Industrial Park, Meigui Street Huayuankou Economic Zone
City State/Province/Country ZIP/Postal Code
Dalian, Liaoning CHINA 116450
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

 
Last Name First Name Middle Name
Wang Guosheng
Street Address 1 Street Address 2
CBAK Industrial Park, Meigui Street Huayuankou Economic Zone
City State/Province/Country ZIP/Postal Code
Dalian, Liaoning CHINA 116450
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last Name First Name Middle Name
Pei Xiangyu
Street Address 1 Street Address 2
CBAK Industrial Park, Meigui Street Huayuankou Economic Zone
City State/Province/Country ZIP/Postal Code
Dalian, Liaoning CHINA 116450
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 Range Aggregate 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
Recipient Recipient 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 1 Street Address 2
 5 CONCOURSE PARKWAY  SUITE 3000
City State/Province/Country ZIP/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