Statement of Changes in Beneficial Ownership (4)
November 15 2021 - 5:33PM
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
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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
*
Ison James |
2. Issuer Name and Ticker or Trading Symbol
ONE STOP SYSTEMS, INC.
[
OSS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chief Sales/Marketing Officer |
(Last)
(First)
(Middle)
2235 ENTERPRISE STREET #110 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/12/2021 |
(Street)
ESCONDIDO, CA 92029
(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 | 11/12/2021 | | F(1) | | 2781 | D | $5.26 | 45553 | D | |
Common Stock | 11/12/2021 | | G | | 3886 (2) | D | $0.00 | 41667 | D | |
Common Stock | | | | | | | | 58526 (2) | I | By Trust (3) |
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 |
Explanation of Responses: |
(1) | The Reporting Person forfeited 2,781 shares of common stock upon conversion of 6,667 vested and outstanding Restricted Stock Units into shares of common stock to cover tax withholdings, using the market price of the issuer's common stock at the time of forfeiture. These Restricted Stock Units were part of the grant reported in Table I of the Form 4 filed by the Reporting Person with the Securities and Exchange Commission on May 21, 2021. |
(2) | On November 12, 2021, the Reporting Person transferred 3,886 shares of common stock to the James J. Ison Jr. & Sha-Marie A Ison TR UA 06 04 2020 James J. Ison Jr. & Sha-Marie A Ison Inter Vivos Revocable Trust, of which the Reporting Person is trustee. The Reporting Person and members of his immediate family are the sole beneficiaries of the trust. |
(3) | These shares are owned directly by James J Ison Jr. and Sha-Marie A Ison Inter Vivos Revocable Trust dated June 4, 2020, and indirectly by James Ison as trustee of the trust. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Ison James 2235 ENTERPRISE STREET #110 ESCONDIDO, CA 92029 |
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| Chief Sales/Marketing Officer |
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Signatures
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/s/ James Ison | | 11/15/2021 |
**Signature of Reporting Person | Date |
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