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QS Energy, Inc. Director's Dealing 2021

Jul 28, 2021

10545_dirs_2021-07-28_7a40f7ff-3085-47a9-af9b-e198b9a78f0b.zip

Director's Dealing

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SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: QS Energy, Inc. (QSEP)
CIK: 0001103795
Period of Report: 2021-06-07

Reporting Person: KYTE CECIL BOND (Director, CEO, CFO)

Non-Derivative Transactions

Date Security Code Shares Price A/D Holdings After Ownership
2021-06-07 Common Stock A 5533333 $0.015 Acquired 10533333 Direct

Derivative Transactions

Date Security Exercise Price Code Shares A/D Expiration Underlying Ownership
2021-06-07 Convertible Note $.02 A Acquired Common Stock (6435000) Direct
2021-06-07 Warrants $.03 A 3217500 Acquired 2022-06-07 Common Stock (3217500) Direct

Footnotes

F1: Reporting Person acquired Issuer's Convertible Note in the principal amount of $128,700, for a purchase price of $117,000, convertible into 6,435,000 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.