Statement of Changes in Beneficial Ownership (4)
January 08 2016 - 5:19PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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0.5
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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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1. Name and Address of Reporting Person
*
Clark Moore
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2. Issuer Name
and
Ticker or Trading Symbol
PEDEVCO CORP
[
PED
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Executive Vice President
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(Last)
(First)
(Middle)
4125 BLACKHAWK PLAZA CIRCLE, SUITE 201
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3. Date of Earliest Transaction
(MM/DD/YYYY)
1/7/2016
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(Street)
DANVILLE, CA 94506
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. 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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8/18/2015
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G
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50000
(1)
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D
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$.003
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1092484
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D
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Common Stock
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12/31/2015
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G
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50000
(1)
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D
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$.003
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1042484
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D
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Common Stock
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1/7/2016
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A
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550000
(2)
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A
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$.22
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1592484
(3)
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D
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Common Stock
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57334
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I
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By minor children
(4)
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. 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
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7. Title and Amount of Securities Underlying Derivative Security
(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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Incentive Stock Option (Right to Buy)
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$.22
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1/7/2016
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A
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280000
(5)
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1/7/2016
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1/7/2021
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Common
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280000
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$.22
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280000
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D
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Incentive Stock Option (Right to Buy)
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$.37
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1/7/2015
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1/7/2020
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Common
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270000
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270000
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D
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Common Stock Warrant (Right to Buy)
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$2.34
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12/16/2013
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12/16/2017
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Common
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1906
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1906
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D
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Common Stock Warrant (Right to Buy)
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$5.25
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3/22/2013
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3/22/2017
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Common
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953
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953
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D
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Incentive Stock Option (Right to Buy)
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$.51
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12/18/2012
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6/18/2022
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Common
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44467
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44467
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D
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Non-Qualified Stock Option (Right to Buy)
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$.51
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12/18/2012
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6/18/2022
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Common Stock
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188867
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188867
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D
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Explanation of Responses:
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(
1)
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Common stock shares were transferred pursuant to a charitable gift in a private transaction.
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(
2)
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Common stock of Issuer granted to Reporting Person and subject to forfeiture as follows: (i) 50% of the shares on the six (6) month anniversary of the Grant Date; (ii) 30% on the twelve (12) month anniversary of the Grant Date; and (iii) 20% on the eighteen (18) month anniversary of the Grant Date, in each case subject to the Recipient being an employee of, or consultant to, the Company on such vesting date, and subject to the terms and conditions of a Restricted Stock Agreement.
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(
3)
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Reporting Person's holdings include: 83,334 shares, 197,750 shares, 280,000 shares, 270,000 and 550,000 shares all issued pursuant to restricted stock grants, and 211,400 shares remaining of Founders Stock.
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(
4)
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Represents 28,667 shares of the Issuer's common stock owned by each of Reporting Person's two minor children.
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(
5)
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Incentive Stock Option granted to Reporting Person with vesting as follows: (i) 50% of the shares on the six (6) month anniversary of the Grant Date; (ii) 30% on the twelve (12) month anniversary of the Grant Date and (iii) 20% on the eighteen (18) month anniversary of the Grant Date, in each case subject to the recipient of the Option being an employee or or consultant to the Company on such vesting date, and subject to the terms and conditions of a Stock Option Agreement.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Clark Moore
4125 BLACKHAWK PLAZA CIRCLE
SUITE 201
DANVILLE, CA 94506
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Executive Vice President
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Signatures
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/s/Clark Moore
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1/8/2016
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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