Statement of Changes in Beneficial Ownership (4)
July 26 2021 - 5:35PM
Edgar (US Regulatory)
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
|
OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden hours per response...
0.5
|
|
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
*
Harrison Jack |
2. Issuer Name and Ticker or Trading Symbol
ONE STOP SYSTEMS, INC.
[
OSS
]
|
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)
2235 ENTERPRISE STREET #110 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
7/22/2021 |
(Street)
ESCONDIDO, CA 92029
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
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 | 7/22/2021 | | M | | 19767 | A | $2.15 | 58884 (1) | 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 |
Common Stock Purchase Warrant | $2.15 | 7/22/2021 | | M | | | 19767 | 4/4/2019 | 4/4/2024 | Common Stock | 19767 | $0.00 | 0 | I | By LLC (2) |
Explanation of Responses: |
(1) | The reporting person beneficially owns the total number of shares reported in this column both directly, as well as indirectly through Jacoma Investments, LLC ("Jacoma") as the sole manager of Jacoma. |
(2) | The Common Stock Purchase Warrant was held directly be Jacoma, and indirectly by the reporting person as the sole manager of Jacoma. |
Reporting Owners
|
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Harrison Jack 2235 ENTERPRISE STREET #110 ESCONDIDO, CA 92029 | X |
|
|
|
Signatures
|
/s/ Jack Harrison | | 7/26/2021 |
**Signature of Reporting Person | Date |
One Stop Systems (NASDAQ:OSS)
Historical Stock Chart
From Mar 2024 to Apr 2024
One Stop Systems (NASDAQ:OSS)
Historical Stock Chart
From Apr 2023 to Apr 2024