Statement of Changes in Beneficial Ownership (4)
June 28 2021 - 8:31AM
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).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
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May Elijah |
2. Issuer Name and Ticker or Trading Symbol
Reliant Holdings, Inc.
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RELT
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner
__X__ Officer (give title below) _____ Other (specify below)
President, CEO and COO |
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(Last)
(First)
(Middle)
12343 HYMEADOW DRIVE, SUITE 3-A |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/15/2021 |
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(Street)
AUSTIN, TX 78750
(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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| Series A Preferred Stock | 6/15/2021 | | A(1) | | 1000 | A | (1) | 1000 | D | |
| Common Stock | | | | | | | | 5200000 | D | |
| Common Stock | | | | | | | | 4475850 (2)(3) | I | Through Voting Agreement (2)(3) |
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) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security
(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) |
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Explanation of Responses: |
| (1) | Issued in consideration for services rendered and to be rendered as an officer of the Issuer. There is not market for the preferred stock. The 1,000 shares of preferred stock vote in aggregate fifty-one percent (51%) of the total vote on all shareholder matters, voting separately as a class. The 1,000 shares of preferred stock have no conversion feature. Exempt from Section 16(b) pursuant to Rule 16b-3. |
| (2) | Pursuant to a Voting Agreement entered into on November 3, 2017, Mr. Michael Chavez provided complete authority to Mr. Elijah May to vote all shares of common stock which Mr. Chavez then held (and any other securities of the Issuer obtained by Mr. Chavez in the future) at any and all meetings of shareholders of the Issuer and via any written consents. The Voting Agreement has a term of ten years, through November 3, 2027, but can be terminated at any time by Mr. May and terminates automatically upon the death of Mr. May. |
| (3) | In connection with his entry into the Voting Agreement, Mr. Chavez provided Mr. May an irrevocable voting proxy to vote the shares covered by the Voting Agreement. Additionally, during the term of such agreement, Mr. Chavez agreed not to transfer the shares covered by the Voting Agreement except pursuant to certain limited exceptions. Due to the Voting Agreement, Mr. May is deemed to also beneficially own the shares of common stock held by Mr. Chavez. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
May Elijah
12343 HYMEADOW DRIVE
SUITE 3-A
AUSTIN, TX 78750 | X | X | President, CEO and COO |
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Signatures
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| /s/ Elijiah May | | 6/28/2021 |
| **Signature of Reporting Person | Date |
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