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Dockter A Scott – ‘4’ for 3/22/19 re: PureBase Corp.

On:  Monday, 8/22/22, at 7:00pm ET   ·   For:  3/22/19   ·   As:  Director, Officer and 10% Owner   ·   Accession #:  1493152-22-23774   ·   File #:  0-55517

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  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 8/22/22  Dockter A Scott                   4          D,O,%Owner  1:18K  PureBase Corp.                    M2 Compliance LLC/FA

Statement of Changes in Beneficial Ownership of Securities by an Insider   —   Form 4   —   SEA’34

Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 4           Statement of Changes in Beneficial Ownership of     HTML     18K 
                Securities by an Insider -- ownership.xml/3.6                    




        

This ‘4’ Document is an XML Data File that may be rendered in various formats:

  Form 4    –   Plain Text   –  SEC Website  –  EDGAR System  –    XML Data    –  <?xml?> File
 

 
SEC Info rendering:  Statement of Changes in Beneficial Ownership of Securities by an Insider
 
FORM 4UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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
OMB APPROVAL
OMB Number:3235-0287
Estimated average burden
hours per response:0.5
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Dockter A Scott

(Last)(First)(Middle)
8631 HIGHWAY 124

(Street)
IONECA95640

(City)(State)(Zip)
2. Issuer Name and Ticker or Trading Symbol
PureBase Corp [ PUBC ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
XDirectorX10% Owner
XOfficer (give title below) Other (specify below)
Chief Executive Officer
3. Date of Earliest Transaction (Month/Day/Year)
3/22/19
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
XForm 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 Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeVAmount(A) or (D)Price
Common stock 3/22/19 3/22/19J (1) 6,000,000D (1)38,665,932D
Common stock 6/26/20 6/26/20J (1) 6,000,000A (1)44,665,932D
Common stock 8/24/21 8/24/21J (1) 1,072,137D (1)43,593,795D
Common stock 8/24/21 8/24/21G 2,500,000D (2)41,093,795D
Common stock 12/7/21 12/7/21J (1) 1,150,000D (1)39,943,795D
Common stock 2/22/22 2/22/22J (1) 1,400,000D (1)38,543,795D
Common stock 6/17/22 6/17/22J (1) 500,000D (1)38,043,795D
Common stock 8/10/22 8/10/22J (1) 1,000,000D (1)37,043,795D
Common stock 9/5/19 9/5/19J (3) 60,248,484A$0.0960,248,484IBy Corporation
Common stock 2/3/20 2/3/20J (3) 6,290,094A$0.0966,538,578IBy Corporation
Common stock 7/7/20 7/20/20J (3) 6,720,905A$0.1673,259,483IBy Corporation
Common stock 7/7/22 7/7/22J (3) 17,020,749A$0.08890,280,232IBy Corporation
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)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares
Stock option (right to buy)$0.38 10/6/21 10/6/21J (4) 116,000,000 (5) 4/6/28Common Stock116,000,000 (6)$0.38116,000,000IBy limited liability company
Explanation of Responses:
(1)  Represents shares paid to third parties as consideration for making loans to the Reporting Person.
(2)  Bona fide gift.
(3)  Represents shares held by US Mine Corporation, of which the Reporting Person is a 33% owner. The Reporting Person disclaims beneficial ownership as to 66% of such shares.
(4)  Option issued to US Mine Corp. as consideration for rights granted under a mineral extraction agreement with the Issuer.
(5)  58,000,000 shares subject to the option were exercisable as of 4/6/22, 29,000,000 shares vest and become exercisable on 10/6/22 and 29,000,000 shares vest and become exercisable on 4/6/23.
(6)  Represents shares exercisable under an option held by US Mine LLC, of which the Reporting Person is a 33.3% owner. The Reporting Person disclaims beneficial ownership as to 66.6% of such shares.
/s/ A. Scott Dockter 8/22/22
** Signature of Reporting PersonDate
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.
____________
Transaction Codes:
    G    Bona fide gift.
    J    Other acquisition or disposition.

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