Christopher Nelson - Dec 31, 2021 Form 5 Insider Report for QSAM Biosciences, Inc. (QSAM)

Signature
/s/ Christopher Nelson
Stock symbol
QSAM
Transactions as of
Dec 31, 2021
Transactions value $
$400,000
Form type
5
Date filed
2/14/2022, 08:58 PM
Next filing
Mar 7, 2022

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction QSAM Preferred Series B Stock Purchase $400K +20 $20,000.00* 20 Jan 22, 2021 Direct
transaction QSAM Series E-1 Preferred Shares Other -850 -100% 0 Dec 6, 2021 Direct F1
transaction QSAM Common Stock Other +2.88M 2.88M Dec 6, 2021 Direct F1
transaction QSAM Common Stock Award +424K +14.69% 3.31M Oct 25, 2020 Direct F2

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction QSAM Options to buy common stock Award $0 +115K $0.00 115K Aug 24, 2021 Common Stock 115K $0.36 Direct F3
transaction QSAM Series E-1 Preferred Shares Award $0 +850 $0.00* 0 Dec 30, 2020 Common Stock 850K $0.00 Direct F4
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Pursuant to reclassification exempt tunde Rule 16b-7, each share of Series E-1 Preferred Stock was reclassified into and exchanged for shares of Common Stock of the Issuer under the terms of Exchange Agreement and Plan of Reorganization as filed with the SEC.
F2 Shares acquired upon conversion of deferred salary and earned bonus.
F3 The option vests semi-annually in two equal installments beginning on 02/24/2022.
F4 Series E-1 Preferred Stock was convertible at any time at the discretion of the holder at a ratio of 1000 shares of Common Stock per Series E-1 Preferred Stock.