Filing Details

Accession Number:
0001008274-10-000001
Form Type:
5
Zero Holdings:
No
Publication Time:
2010-02-12 12:00:00
Reporting Period:
2009-12-31
Filing Date:
2010-02-12
Accepted Time:
2010-02-12 13:34:58
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1025362 Golden Queen Mining Co Ltd GQM Metal Mining (1000) 000000000
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1008274 T Landon Clay C/O East Hill Management Co
10 Memorial Blvd, Suite 902
Providence RI 02903
No No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2009-07-15 1,200,000 $0.65 17,047,019 No 4 P Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Direct
Reported Non-Derivative Holdings
Sec. Name Remaning Holdings Nature of Ownership Explanation
Common Stock 30,777 Indirect By corporation
Common Stock 807,250 Indirect By corporation
Common Stock 2,351 Indirect By spouse
Common Stock 3,462,906 Indirect By sons
Common Stock 4,797,094 Indirect By trusts
Reported Derivative Holdings
Sec. Name Sec. Type Price Date Expiration Date Amount Remaning Holdings Nature of Ownership
Common Stock Stock Options $0.26 2009-01-28 2014-01-28 300,000 300,000 Indirect
Expiration Date Amount Remaning Holdings Nature of Ownership
2014-01-28 300,000 300,000 Indirect
Footnotes
  1. Price is in Canadian dollars.
  2. Includes 26,114 shares held by LTC Corp. and 4,663 shares held by LTC Pension and Profit Sharing Plan.
  3. Represents shares held by Arctic Coast Petroleums Ltd. ("Arctic Coast"). The reporting person owned 50% of the shares of Arctic Coast and transferred his interest in Arctic Coast on October 22, 2009 to the Clay Family 2009 Irrevocable Trust u/a dated April 14, 2009, the trustees of which are Thomas M. Clay and Harris Clay. The reporting person disclaims beneficial ownership of the shares held by Arctic Coast.
  4. Represents shares held by reporting person's spouse, Lavinia D. Clay. The reporting person disclaims beneficial ownership of the shares held by his spouse.
  5. Represents shares held by reporting person's four sons including 868,522 shares held by Thomas M. Clay, 868,524 shares held by Richard T. Clay, 862,930 shares held by Landon H. Clay, and 862,930 shares held by Cassius M.C. Clay. The reporting person disclaims beneficial ownership of the shares held by his sons.
  6. Represents a Stock Option granted to reporting person's son, Thomas M. Clay, on January 28, 2009. Thomas M. Clay is a director of the issuer. The reporting person disclaims beneficial ownership of the derivative securities held by his son.
  7. Represents shares held by various charitable annuity lead trusts of which reporting person is the donor (the "Trusts"). Harris Clay is the trustee of the Trusts and each of the reporting person's sons' has a remainder beneficial interest in the Trusts. The reporting person provides investment advisory services to the Trusts. The reporting person disclaims beneficial ownership of the shares held by the Trusts.