SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 02/11/2022 | 3. Issuer Name and Ticker or Trading Symbol Vivakor, Inc. [ VIVK ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. 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 Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 4,189,690(2) | I | See footnote(1) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Options to purchase shares of common stock | (3) | (4) | Common Stock | 166,667 | 13.2 | D |
Explanation of Responses: |
1. The shares of common stock ("Common Stock") beneficially owned by Mr. Nicosia includes 4,189,428 Common Stock held by AKMN Irrevocable Trust and 262 Common Stock held by Nicosia Family Trust. Mr. Nicosia is the trustee of the AKMN Irrevocable Trust. |
2. Common stock, par value $0.0001 per share. |
3. These options to purchase shares of Common Stock (the "Options") of Vivakor, Inc. (the "Company"), were issued to Mr. Nicosia on September 29, 2020 (the "The Date Of issuance"), pursuant to that certain Employment Agreement by and between Mr. Nicosia and the Company, dated September 24, 2020. The Options will vest on the five-year anniversary of the Date of Issuance. |
4. The Options' expiration date is February 11, 2027. |
/s/ Matthew Nicosia | 02/18/2022 | |
** 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 5 (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. |