David Charles Link - 31 Dec 2021 Form 5 Insider Report for QSAM Biosciences, Inc.

Reporting relationship: Director
Issuer ticker: N/A
Reported as of: 31 Dec 2021
Net transaction value: $0
SEC form: 5
Accepted by SEC: 15 Feb 2022, 05:11:47 UTC
Prior SEC filing: 22 Oct 2021
Next SEC filing: 09 Dec 2022
Source filing: View source filing
Reporting owner signature: /s/ Charles Link Jr.

Key filing fact

David Charles Link filed Form 5 for QSAM Biosciences, Inc. on 15 Feb 2022.

Key facts

This page summarizes David Charles Link's Form 5 filing for QSAM Biosciences, Inc..
4 reported transactions and 2 derivative rows are listed below.
Accepted by SEC: 15 Feb 2022, 05:11.

Change

Previous filing in this sequence was filed on 22 Oct 2021.
Current net transaction value: $0.

Research use

This tells you what this filing adds before you inspect full transaction and derivative tables.
You can trace every row back to the original SEC filing document.

Evidence

Official SEC source

Ownership activity is grounded in SEC Form 5 disclosures.

View source filing

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

QSAM transaction

Series E-1 Preferred Stock

Other

Transaction value
Shares: -850
Change %: -100%
Price
Shares after: 0
Date: 06 Dec 2021
Ownership: Direct
Footnotes: F1

QSAM transaction

Common Stock

Other

Transaction value
Shares: +2,883,943
Change %
Price
Shares after: 2,883,943
Date: 06 Dec 2021
Ownership: Direct
Footnotes: F1

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

QSAM transaction Derivative

Options to buy common

Award

Transaction value: $0
Shares: +55,000
Change %
Price: $0.000000
Shares after: 55,000
Date: 24 Aug 2021
Ownership: Direct
Underlying class: Common Stock
Underlying amount: 55,000
Exercise price: $0.3600
Footnotes: F2

QSAM transaction Derivative

Series E-1 Preferred Shares

Award

Transaction value: $0
Shares: +850
Change %
Price: $0.000000^*
Shares after: 0
Date: 15 Feb 2021
Ownership: Direct
Underlying class: Common Stock
Underlying amount: 850,000
Exercise price: $0.000000
Footnotes: F3

^* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 3 footnotes

Footnote F1

Pursuant to reclassification exempt under 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.

Footnote F2

The option vests semi-annually in two equal installments beginning on 02/24/2022.

Footnote F3

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.