SEC Form 4
FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol Petrolia Energy Corp [ BBLS ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Date of Earliest Transaction (Month/Day/Year) 04/18/2016 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock (Restricted) | 12/13/2016 | J | 3,624,030(1) | A | $0.18 | 4,084,030 | I | Critical Communication LLC | ||
Common Stock (Restricted) | 05/30/2017 | J | 1,038,529(2) | A | $0.21 | 5,122,559 | I | Critical Communication LLC | ||
Common Stock (Restricted) | 07/21/2017 | J | 1,483,613(3) | A | $0.14 | 6,606,172 | I | Critical Communication LLC | ||
Common Stock (Restricted) | 07/21/2017 | M | 1,100,000(4) | A | $0.14 | 7,716,172(4) | I | Critical Communication LLC |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Warrant | $0.12 | 04/18/2016 | 05/23/2017 | A | 500,000(5) | 05/23/2017 | 05/23/2020 | Common Stock | 500,000 | $0 | 610,000 | D | |||
Warrant | $0.12 | 05/23/2017 | 05/23/2017 | A | 500,000(5) | 05/23/2017 | 05/23/2020 | Common Stock | 500,000 | $0 | 1,100,000 | D | |||
Warrant | (6) | 02/01/2018 | (6) | C | 1,100,000(4) | (6) | (6) | Common Stock | 1,100,000 | (4) | 0 | I | Critical Communication LLC |
Explanation of Responses: |
1. Shares received through the acquisition of 10% net WI in the SUDS Field. This represents the ownership interest in which Critical Communication LLC held through its position held in the property. |
2. Shares received through the additional acquisition by Petrolia of 40% net WI in the SUDS Field. This represents the ownership interest in which Critical Communication LLC held through its position held in the property. |
3. Shares received through the settlement of the $3 million Debt owed to Jovian for the acquisition of the remaining 50% WI in SUDS. This represents the ownership interest in which Critical Communication LLC held through its position held in the property. |
4. Mr. Beasley has agreed to exercise all the warrants that he holds at this time, to settle a significant portion of the outstanding invoices issued through Critical Communication LLC. The exercising of warrants was approved by the Board. |
5. Warrants issued through the Directors Compensation package for annual service on Petrolia's Board of Directors. |
6. varies |
/s/ Quinten S Beasley | 02/14/2018 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |