FORM 4
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT 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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OMB APPROVAL
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Estimated average burden hours per response... | 0.5 |
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(Print or Type Responses)
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1.Title of Security (Instr. 3)
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2. Transaction Date (Month/Day/Year)
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2A. Deemed Execution Date, if any (Month/Day/Year)
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3. Transaction Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock |
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| 1,125,000 | D |
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Common Stock |
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| 2,000,000 | I | Klutch Financial Corp. |
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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) |
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)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date (Month/Day/Year)
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3A. Deemed Execution Date, if any (Month/Day/Year)
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4. Transaction Code (Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5)
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6. Date Exercisable and Expiration Date (Month/Day/Year)
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7. Title and Amount of Underlying Securities (Instr. 3 and 4)
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8. Price of Derivative Security (Instr. 5)
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9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Stock Options |
$1.29 |
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| 4/28/17 (1) | 4/28/27 | Common | 350,000 |
| 350,000 | D |
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Stock Options |
$0.53 |
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| 4/3/20 (2) | 4/2/30 | Common | 250,000 |
| 600,000 | D |
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Stock Options |
$1.09 |
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| 3/31/21 (3) | 3/31/31 | Common | 250,000 |
| 850,000 | D |
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Reporting Owners
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
KEAY AARON 7325 BLENHEIM STREET VANCOUVER, A1 V6N 1S2 |
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| Former Director |
Signatures
/s/ Aaron Keay | |
3/23/23 |
**Signature of Reporting Person | Date |
Explanation of Responses:
* | 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) | 1/4 of the options will vest on April 28, 2017 (the "Date of Grant"); on each anniversary date of the Date of Grant, additional 1/4 of the options will vest; provided, however, the options will stop vesting in the event that the Reporting Person's continuous service terminates (other than upon the Reporting Person's death or disability) while the options will continue vesting in the event that the Reporting Person's continuous service terminates as a result of the Reporting Person's death or disability. |
(2) | 50% vest on April 3, 2020 and 50% vest on April 3, 2021. |
(3) | 50% vest on March 31, 2021 and 50% vest on March 31, 2022. |
Remarks: On March 13, 2023, the Reporting Person resigned as a director of The Alkaline Water Company Inc. |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
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