QS Energy, Inc. — Director's Dealing 2017

Jun 2, 2017

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: QS Energy, Inc. (QSEP)
CIK: 0001103795
Period of Report: 2017-05-31

Reporting Person: Bundros Thomas A. (Director)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2017-05-31	Common Stock	C	2200000	$0.05	Acquired	2200000	Direct

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2017-05-31	Convertible Note	$0.05	A		Acquired		Common Stock (2200000)	Direct
2017-05-31	Warrants	$0.05	A	1100000	Acquired	2018-05-31	Common Stock (1100000)	Direct
2017-05-31	Convertible note	$0.05	C		Disposed		Common Stock (2200000)	Direct

Footnotes

F1: Reporting Person acquired Issuer's Convertible Note in the principal amount of $110,000, for a purchase price of $100,000, convertible into 2,200,000 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.

F4: Reporting Person converted the Convertible Note listed above and described in Footnote 1 of this Form 4.