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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series B Convertible Preferred Stock (1) | $ 0.027 | 12/21/2020 | A | 18 (1) | 05/01/2021(2) | (3) | Common Stock | 666,667 | $ 1,000 (1) | 38 (1) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Thomsen Scott Viggo 6035 SOUTH LOOP EAST HOUSTON,, TX 77033 |
X |
/s/ Scott Thomsen | 12/23/2020 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | On December 21, 2020, pursuant to a liability reduction plan, C-Bond Systems, Inc. (the "Company") issued Mr. Thomsen 18 shares of Series B Convertible Preferred Stock, par value $0.10 ("Series B"). The Series B has a stated value of $1,000 per share and is convertible into shares of common stock, par value $0.001 ("Common Stock"), at $0.027 per share, the closing price of the Common Stock on the date of issuance, subject to adjustment as described in the Company's Certificate of Designations of Preferences, Rights and Limitations of Series B Preferred Stock. |
(2) | The shares of Series B granted to Mr. Thomsen will vest on May 1, 2021. |
(3) | No expiration date. |