Statement of Changes in Beneficial Ownership (4)
January 12 2022 - 06:40PM
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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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 * D'Ambrosio Lance
Varro |
2. Issuer Name and Ticker or Trading
Symbol Riot Blockchain, Inc. [ RIOT ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
_____ Officer (give title
below) _____ Other
(specify below)
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(Last)
(First)
(Middle)
C/O RIOT BLOCKCHAIN, INC., 3855 AMBROSIA STREET, SUITE
301 |
3. Date of Earliest Transaction (MM/DD/YYYY)
1/10/2022
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(Street)
CASTLE ROCK, CO 80109
(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 |
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 |
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 |
Restricted Stock Units |
$0.00 (1) |
1/10/2022 |
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A |
|
12500 |
|
(2) |
(2) |
Common Stock |
12500 |
$0.00 (2) |
20000 (3) |
D |
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Explanation of
Responses: |
(1) |
Vested restricted stock
units ("RSUs") granted under the Riot Blockchain, Inc. 2019 Equity
Incentive Plan, as amended, (the "Plan") covert into shares of the
Issuer's Common Stock, no par value per share, on a one-for-one
basis upon settlement by the Issuer in accordance with the
procedures of the Plan |
(2) |
These 12,500 RSUs were
awarded as compensation for the Reporting Person's service as an
independent director on the Issuer's Board of Directors for the
year ending December 31, 2022, as approved by the Issuer's
Compensation and Human Resources Committee on January 10, 2022.
These 12,500 RSUs are eligible to vest in four equal quarterly
installments of 3,125 RSUs following the grant date. |
(3) |
Represents the total direct
and indirect beneficial ownership of the security held by the
Reporting Person immediately following the issuance reported by
this Form 4. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
D'Ambrosio Lance Varro
C/O RIOT BLOCKCHAIN, INC.
3855 AMBROSIA STREET, SUITE 301
CASTLE ROCK, CO 80109 |
X |
|
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Signatures
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/s/ Lance Varro D'Ambrosio |
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1/12/2022 |
**Signature of
Reporting Person |
Date |
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