Fiona Mary Curtis Form 5 KIDOZ / Fiona Mary Curtis ownership change

SEC Form 5

FORM 5

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL 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).

Form 3 Holdings Reported.

Form 4 Transactions Reported.

1. Name and Address of Reporting Person^*

Curtis Fiona Mary

(Last) (First) (Middle)

ARD NA MARA

PO BOX 1127,

(Street)

LITTLE HARBOUR 1A AI-2640

(City) (State) (Zip)

2. Issuer Name and Ticker or Trading Symbol
KIDOZ INC. [ KDOZF ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2021

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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 at end of Issuer's Fiscal Year (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
				Amount	(A) or (D)	Price
Common Stock							50,000	D

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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)
					(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Employee Stock (Right to Buy)	$0.43						11/08/2017	11/08/2022	Common Stock	25,000(1)		300,000	D
Employee Stock (Right to Buy)	$0.42						06/04/2018	06/04/2023	Common Stock	175,000(2)		300,000	D
Employee Stock (Right to Buy)	$0.39						02/01/2021	02/01/2026	Common Stock	50,000(3)		300,000	D
Employee Stock (Right to Buy)	$0.81						04/06/2021	04/06/2026	Common Stock	50,000(4)		300,000	D

Explanation of Responses:

1. Ms. F. Curtis was granted 25,000 stock options at CAD$0.54 (approximately US$0.43) on November 8, 2017. These options vest immediately.

2. Ms F. Curtis was granted 175,000 stock options at CAD$0.54 (approximately US$0.42) on June 4, 2018. These options vest immediately.

3. Ms. F. Curtis was granted 50,000 stock options at CAD$0.50 (approximately US$0.39) on February 1, 2021. These options vest 10% on grant date, 15% after one year and 2% per month thereafter.

4. Ms. F. Curtis was granted 50,000 stock options at CAD$1.02 (approximately US$0.813) on April 6, 2021. These options vest at 2% per month.

	/s/ F. Curtis	02/11/2022
	** 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 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).
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