Statement of Changes in Beneficial Ownership (4)
May 14 2021 - 02:34PM
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
Estimated average burden
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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 * McLernon John R. |
2. Issuer Name and Ticker or Trading
Symbol City Office REIT, Inc. [ CIO ] |
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)
200 GRANVILLE STREET, 19TH FLOOR |
3. Date of Earliest Transaction (MM/DD/YYYY)
5/13/2021
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(Street)
VANCOUVER, A1 V6C 2R6
(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 |
Common Stock |
5/13/2021 |
|
M |
|
4460 |
A |
(1) |
14739 |
D |
|
Common Stock |
5/13/2021 |
|
F |
|
1338 |
D |
(1) |
13401 |
D |
|
Common Stock |
|
|
|
|
|
|
|
7500 |
I |
McLernon Holdings Ltd. (2) |
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 |
(1) |
5/13/2021 |
|
M |
|
|
4460 |
(3) |
(3) |
Common Stock |
4460 |
$0.00 |
9888 |
D |
|
Explanation of
Responses: |
(1) |
In accordance with the
Company's Equity Incentive Plan (the "Equity Incentive Plan"),
Restricted Stock Units (as defined in the Equity Incentive Plan)
convert into common stock on a one-for-one basis. |
(2) |
The Reporting Person
disclaims beneficial ownership of these securities as this report
shall not be deemed an admission that the Reporting Person is the
beneficial owner of these securities for the purposes of Section 16
or any other purpose. |
(3) |
The restricted stock units
reported herein have vested and converted to common shares as at
May 13, 2021. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
McLernon John R.
200 GRANVILLE STREET, 19TH FLOOR
VANCOUVER, A1 V6C 2R6 |
X |
|
|
|
Signatures
|
/s/ John McLernon |
|
5/14/2021 |
**Signature of Reporting
Person |
Date |
City Office REIT (NYSE:CIO)
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