QS Energy, Inc. — Director's Dealing 2016

Aug 8, 2016

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: QS Energy, Inc. (QSEP)
CIK: 0001103795
Period of Report: 2016-08-05

Reporting Person: Dickson Don (Director)

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2016-08-05	Convertible Note	$0.10	A	70000	Acquired		Common Stock (770000)	Direct
2016-08-05	Warrants	$0.10	A	385000	Acquired	2017-08-04	Common Stock (385000)	Direct

Footnotes

F1: Reporting Person acquired Issuer's Convertible Note in the principal amount of $77,000, for a purchase price of $70,000, convertible into 770,000 shares of common stock of Issuer.

F2: Not applicable.

F3: Reporting Person acquired Issuer's Warrants as part of Reporting Person's purchase of Issuer's Convertible Note reported above.