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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
6% Convertible Promissory Note | $ 1 | 02/01/2021 | C | $ 100,000 | 12/30/2020 | 05/10/2021 | Common Stock | 100,000 | $ 0 | 0 | D | ||||
6% Convertible Promissory Note | $ 0.375 | 02/01/2021 | C | $ 1,500,000 | 09/18/2020 | 05/10/2021 | Common Stock | 4,000,000 | $ 0 | 0 | I | See Footnote (4) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
McCabe Greg 500 WEST TEXAS AVE. SUITE 890 MIDLAND, TX 79701 |
X | X |
/s/ Greg McCabe | 04/05/2021 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Mr. McCabe converted the entire principal amount of the $100,000 convertible promissory note issued by the issuer in December 2020 into common stock of the issuer at its conversion price of $1.00 per share, totaling 100,000 shares. |
(2) | McCabe Petroleum Corporation ("MPC") converted the entire principal amount of the $1.5 million convertible promissory note issued by the issuer in September 2020 (the "MPC Note") into common stock at its conversion price of $0.375 per share, totaling 4,000,000 shares. |
(3) | On December 22, 2020, Mr. McCabe filed a Form 4 that reported MPC's acquisition of 313,480 shares of common stock on November 11, 2020. That Form 4 incorrectly stated that the amount of securities beneficially owned by MPC following that transaction was 3,126,960 shares of common stock. The correct amount was 2,813,480 shares of common stock. |
(4) | Mr. McCabe is the sole owner of MPC, the holder of the MPC Note and the shares of the issuer's common stock issued in connection with the conversion thereof. |
(5) | Mr. McCabe owns 50% of the outstanding membership interests of G Mc Exploration, LLC, which is the record owner of 797,099 shares of the issuer's common stock. |