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Layton Earl Thomas – ‘5’ for 4/30/21 re: Lux Amber, Corp.

On:  Wednesday, 11/17/21, at 2:19pm ET   ·   For:  4/30/21   ·   Accession #:  1703746-21-2   ·   File #:  0-56207

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

11/17/21  Layton Earl Thomas                5                      1:6K   Lux Amber, Corp.

Annual Statement of Changes in Beneficial Ownership of Securities by an Insider   —   Form 5   —   SEA’34
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 5           Annual Statement of Changes in Beneficial           HTML      3K 
                Ownership of Securities by an Insider --                         
                primary_doc.xml/3.6                                              




        

This ‘5’ Document is an XML Data File that may be rendered in various formats:

  Form 5    –   Plain Text   –  SEC Website  –  EDGAR System  –    XML Data    –  <?xml?> File
 

 
SEC Info rendering:  Annual Statement of Changes in Beneficial Ownership of Securities by an Insider
 
FORM 5UNITED 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
OMB APPROVAL
OMB Number:3235-0362
Estimated average burden
hours per response:1.0
  
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*
Layton Earl Thomas

(Last)(First)(Middle)
6136 FRISCO SQUARE BLVD.
SUITE 400, #237

(Street)
FRISCOTX75034

(City)(State)(Zip)
2. Issuer Name and Ticker or Trading Symbol
Lux Amber, Corp. [ LXAM ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
XDirector 10% Owner
XOfficer (give title below) Other (specify below)
Chairman and CEO
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
4/30/21
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 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 3/17/21 (1) 3/17/21J (2)1,096,250D$1 (3)3,618,750D
Common Stock 4/20/21 (4) 4/20/21J (5)1,125,000D$1 (6)3,618,750D
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 ExercisableExpiration DateTitleAmount or Number of Shares
Explanation of Responses:
(1)  Eleven (11) separate transactions occurred simultaneously
(2)  Delivery of shares comprising collateral, in lieu of payment of the promissory note whose repayment was secured by such shares
(3)  The price was a function of the timing of the underlying transaction, and varied from $0.40 to $1.00
(4)  Thirteen (13) separate transactions occurred simultaneously
(5)  Delivery of shares comprising collateral, in lieu of payment of the promissory note whose repayment obligation was secured by such shares
(6)  The price was a function of the timing of the underlying loan transaction, and varied from $0.13 to $1.00
E. Thomas Layton 9/19/20
** 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 Code:
    J    Other acquisition or disposition.

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Filing Submission 0001703746-21-000002   –   Alternative Formats (Word / Rich Text, HTML, Plain Text, et al.)

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