Filing Details
- Accession Number:
- 0001493152-22-004630
- Form Type:
- 5
- Zero Holdings:
- No
- Publication Time:
- 2022-02-15 06:14:47
- Reporting Period:
- 2021-12-31
- Accepted Time:
- 2022-02-15 06:14:47
- SEC Url:
- Form 4 Filing
Issuer
| Cik | Name | Symbol | Sector (SIC) | IRS No |
|---|---|---|---|---|
| 1310527 | Qsam Biosciences Inc. | QSAM | Specialty Cleaning, Polishing And Sanitation Preparations (2842) | 201602779 |
Insiders
| Cik | Name | Reported Address | Insider Title | Director | Officer | Large Shareholder | Other |
|---|---|---|---|---|---|---|---|
| 1422574 | R Douglas Baum | 9442 Capital Of Texas Hwy N, Plaza 1, Suite 500 Austin TX 78759 | Ceo & Director | Yes | Yes | No | No |
Reported Non-Derivative Transactions
| Sec. Name | Acquisiton - Disposition | Date | Amount | Price | Remaning Holdings | Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|---|---|---|---|---|---|
| Series B Preferred Stock | Acquisiton | 2021-01-22 | 3 | $3,000.00 | 3 | No | 4 | P | Direct | |
| Series E-1 Preferred Stock | Disposition | 2021-12-06 | 2,975 | $0.00 | 0 | No | 5 | J | Direct | |
| Common Stock | Acquisiton | 2021-12-06 | 10,093,800 | $0.00 | 10,093,800 | No | 5 | J | Direct |
| Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|
| No | 4 | P | Direct | |
| No | 5 | J | Direct | |
| No | 5 | J | Direct |
Reported Derivative Transactions
| Sec. Name | Sec. Type | Acquisiton - Disposition | Date | Amount | Price | Amount - 2 | Price - 2 |
|---|---|---|---|---|---|---|---|
| Common Stock | Series E-1 Preferred Stock | Acquisiton | 2020-12-30 | 2,975 | $0.00 | 2,975,000 | $0.00 |
| Common Stock | Options to buy common Stock | Acquisiton | 2020-01-14 | 8,000 | $0.00 | 8,000 | $0.50 |
| Common Stock | Options to buy common Stock | Acquisiton | 2021-08-24 | 125,000 | $0.00 | 125,000 | $0.36 |
| Remaning Holdings | Exercise Date | Expiration Date | Equity Swap Involved | Transaction Form Type | Transaction Code | Nature of Ownership |
|---|---|---|---|---|---|---|
| 0 | No | 4 | A | Direct | ||
| 8,000 | 2025-01-14 | No | 4 | A | Direct | |
| 125,000 | 2031-08-23 | No | 4 | A | Direct |
Footnotes
- Pursuant to reclassification exempt under Rule 16b-7, each share of Series E-1 Preferred Stock was reclassified into andexchanged for shares of Common Stock of the Issuer under the terms of Exchange Agreement and Plan of Reorganization asfiled with the SEC.
- Series E-1 preferred stock was convertible at any time at the discretion of the holder at a ratio of 1000 shares of common stockper Series E-1 preferred stock.
- The options vests annually in two equal installments beginning on 1/14/2021.
- The option vestssemi-annually in two equal installments beginning on 02/24/2022.
Billionaire Hedge Funds
