| 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*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol Moxian, Inc. [ MOXC ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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| 3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year) 09/30/2016 | ||||||||||||||||||||||||||
| 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 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 | 11/19/2013 | 11/19/2013 | P4 | 5,000 | A | $0.1 | 29,820,000 | I | by Good Eastern(1) | ||||||
| Common Stock | 11/22/2013 | 11/22/2013 | P4 | 661,000 | A | $0.085 | 29,820,000 | I | by Good Eastern(1) | ||||||
| Common Stock | 11/14/2013 | 11/14/2013 | P4 | 1,332,000 | A | $112,379 | 29,820,000 | I | by Stellar(1) | ||||||
| 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) | |||
| (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
| Explanation of Responses: |
| 1. see notes below |
| Remarks: |
| Mr. Tan was appointed as the director of MOXC on February 13, 2015 and was appointed as the CEO and President of MOXC on June 30, 2015. On September 28, 2017, Mr. Tan resigned from his positions as a director of MOXC and from all directorship positions with all MOXC subsidiaries and also resigned from his position as CEO of MOXC and from all officer positions with MOXC and its subsidiaries, effective September 29, 2017. Mr. Tan is a member and director of Good Eastern Investment Holdings Limited ("Good Eastern"). On November 19, 2013, Good Eastern acquired 5,000 shares of MOXC in exchange for $0.10 per share. On November 22, 2013, Good Eastern acquired 661,000 shares of MOXC in exchange for $0.085 per share. On December 13, 2013 MOXC implemented a 60-for-1 forward stock split, causing the shares set forth above to increase to 39,960,000 shares. On February 22, 2016, MOXC and Good Eastern agreed to a cancellation of shares that resulted in Good Eastern owning 19,980,000 shares of MOXC, and on June 20, 2016, the MOXC effected a 1 for 2 reverse stock split, which caused the shares MOXC held by Good Eastern to be adjusted to 9,990,000. See Exhibit 1 attached here for additional information. Please see Exhibit 1 for additional information required by this Form 5 for which there was not available room here. |
| /s/ James Mengdong Tan | 02/28/2018 | |
| ** 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. | ||
