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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 | ||||||||
Convertible Promissory Note | $ 0.50 | 12/07/2020 | C | 0 (3) | 06/05/2020 | (4) | Common Stock | 3,103,028 | $ 0 | 0 | I | IDTEC, LLC | |||
8% Series A-1 Preferred Stock | $ 1 | 12/15/2020 | C | 0 (5) | 12/12/2019 | 12/22/2029 | Common Stock | 2,743,169 | (6) | 0 | I | SOBR SAFE, LLC |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Graham Gary John 6400 S. FIDDLERS GREEN CIRCLE SUITE 525 GREENWOOD VILLAGE, CO 80111 |
X |
/s/ Gary Graham | 12/31/2020 | |
**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) | Shares were issued to IDTEC, LLC upon conversion of an aggregate of $1,551,514 in principal and interest owed to IDTEC, LLC under a convertible promissory note. The Reporting Person is the Manager of a limited liability company that is the Manager of IDTEC, LLC. |
(2) | Shares were issued to SOBR Safe, LLC upon the conversion of the Issuer's 8% Series A-1 Convertible Preferred Stock owned by SOBR Safe, LLC, plus accrued dividends owed through the date of conversion. The Reporting Person is the Manager of a limited liability company that is the Manager of SOBR Safe, LLC. |
(3) | IDTEC, LLC converted the principal and interest owed to it under that certain SOBR Safe, Inc. Convertible Promissory Note dated June 6, 2020 into 3,103,028 shares of the Issuer's common stock. The Reporting Person is the Manager of a limited liability company that is the Manager of IDTEC, LLC. |
(4) | The promissory note did not have an expiration date. |
(5) | SOBR Safe, LLC converted its shares of 8% Series A-1 Convertible Preferred Stock, and accrued dividends, into 2,743,169 shares of the Issuer's common stock. The Reporting Person is the Manager of a limited liability company that is the Manager of SOBR Safe, LLC. |
(6) | SOBR Safe, LLC acquired the 8% Series A-1 Preferred Stock in exchange for $2,700,000. |