Statement of Changes in Beneficial Ownership (4)
February 26 2020 - 6:06PM
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
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Battinelli Salvatore F |
2. Issuer Name and Ticker or Trading Symbol
SIGMA LABS, INC.
[
SGLB
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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)
3900 PASEO DEL SOL |
3. Date of Earliest Transaction
(MM/DD/YYYY)
1/28/2020 |
(Street)
SANTA FE, NM 87507
(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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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 |
Series E Preferred Stock (1) | $1.03 | 1/28/2020 | | A | | 16.67 | | 1/28/2020 | (1) | Common Stock | 31756 (2) | $1500.00 | 16.67 | D | |
Warrants to Purchase Common Stock | $1.13 | 1/28/2020 | | A | | 24272 | | 7/29/2020 | 7/28/2025 | Common Stock | 24272 | $0.00 (1) | 24272 | D | |
Explanation of Responses: |
(1) | Pursuant to a Securities Purchase Agreement between the Company and the Reporting Person, the Reporting Person purchased 16.67 shares of the Company's Series E Preferred Stock (the "Preferred Shares") and warrants to purchase 24,272 shares of the Company's Common Stock for an aggregate purchase price of $25,000 or $1,500 per Preferred Share (the "Stated Value"). Dividends accrue on a monthly basis of 9% per annum and shall increase the Stated Value. The holder shall have the right to convert the Preferred Shares into common shares at a conversion rate determined by dividing the Conversion Amount by $1.03. The Conversion Amount is the sum of the Stated Value (including as a result of accrued dividends) plus the amount of any dividend that, but for the conversion, would have accrued at the dividend rate for the three year period commencing January 28, 2020. The Preferred Shares have no expiration date. |
(2) | Represents the maximum amount of common shares issuable upon conversion as described in footnote 1. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Battinelli Salvatore F 3900 PASEO DEL SOL SANTA FE, NM 87507 | X |
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Signatures
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/s/ Salvatore F. Battinelli | | 2/26/2020 |
**Signature of Reporting Person | Date |
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