Amended Statement of Changes in Beneficial Ownership (4/a)
May 20 2020 - 6:57PM
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
*
HINSHAW MICHAEL |
2. Issuer Name and Ticker or Trading Symbol
McorpCX, Inc.
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MCCX
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director __X__ 10% Owner __X__ Officer (give title below) _____ Other (specify below) President of McorpCX, LLC |
(Last)
(First)
(Middle)
201 SPEAR STREET, SUITE1100 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
9/3/2019 |
(Street)
SAN FRANCISCO, CA 94105
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
9/17/2019 |
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 | 9/3/2019 | | S | | 0 (1) | D | (1) | 5200000 | D | |
Common stock | 9/3/2019 | | G | | 0 (2) | D | (2) | 5200000 (3) | D | |
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 Form 4, as originally filed on September 17, 2019, reported two sales by the Reporting Person, each of 300,000 shares of common stock of McorpCX, Inc. The stock purchase agreements pursuant to which those shares of common stock were to be sold were terminated prior to the consummation of the sales of the shares subject to these agreements, and thus this amendment to the Form 4 removes the originally reported transactions. |
(2) | The Form 4, as originally filed on September 17, 2019, reported the gifting of 250,000 shares of common stock of McorpCX, Inc. (incorrectly identified on such Form 4 as "Stock Options"). The gift agreement pursuant to which those shares of common stock were to be gifted by the Reporting Person to a third party was terminated prior to the consummation of the transfer of the shares of common stock subject to the gift agreement, and thus this amendment to the Form 4 removes the originally reported transaction. |
(3) | Represents the number of shares beneficially owned by the Reporting Person as of the date of this amended Form 4. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
HINSHAW MICHAEL 201 SPEAR STREET SUITE1100 SAN FRANCISCO, CA 94105 |
| X | President of McorpCX, LLC |
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Signatures
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/s/ Andrew J. Bond, Attorney in Fact for Michael Hinshaw | | 5/20/2020 |
**Signature of Reporting Person | Date |
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