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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 | ||||||||
Non-Qualified Stock Option (right to buy) | $ 1 | 08/21/2020 | A | 14,200 | (4) | 08/20/2030 | Common Stock | 14,200 | $ 0 | 14,200 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 1 | 09/23/2021(1) | (4) | M | 14,200 | (4) | 08/20/2030 | Common Stock | 14,200 | $ 0 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
CARLISE THERESA C/O ORBSAT CORP 18851 N.E. 29TH AVE., SUITE 700 AVENTURA, FL 33180 |
Chief Accounting Officer |
/s/ Theresa Carlise | 09/24/2021 | |
**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) | This Form 4 Amendment is being submitted to correct the disclosure regarding the options granted on 8/21/2020. On May 28, 2021, the Issuer effected a 1-for-5 reverse stock split of its common stock (the "Reverse Stock Split"). The amount of securities reported on this Form 4 have been adjusted to reflect the Reverse Stock Split. |
(2) | Represents restricted stock awarded by the Board of Directors on 8/21/2020 and granted pursuant to the Company's 2020 Equity Incentive Plan. |
(3) | On September 23, 2021, the reporting person exercised options to purchase 14,200 shares at $1.00 per share. The Reporting Person paid the exercise price on a cashless basis (a "net exercise"), resulting in the Issuer withholding 2,763 of the option shares to pay the exercise price and issuing to the Reporting Persons the remaining 11,437 shares. |
(4) | The grant of these options was approved by the Registrants Board of Directors on 8/21/2020 and subject to the Company's 2020 Equity Incentive Plan. All options vested immediately upon grant date. |