Amended Statement of Changes in Beneficial Ownership (4/a)
22 December 2021 - 5:20AM
Edgar (US Regulatory)
FORM 4
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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
*
LAZARAN FRANK |
2. Issuer Name and Ticker or Trading Symbol
ALKALINE WATER Co INC
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WTER
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
6809 LAHONTAN DRIVE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
9/30/2021 |
(Street)
FORT WORTH, TX 76132
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
11/18/2021 |
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 | | | | | | | | 38333 | D | |
Common Stock | 9/30/2021 | | C | | 50000 | A | (3) | 88333 | D | |
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 |
Stock Options | $0.53 | | | | | | | 4/3/2020 (1) | 4/2/2030 | Common | 100000 | | 100000 | D | |
Stock Options | $1.09 | | | | | | | 3/31/2021 (2) | 3/31/2031 | Common | 50000 | | 150000 | D | |
Subscription Receipts | $1.05 | | | | | | | (3) | (3) | Units | 50000 | | 50000 | D | |
Subscription Receipts | $1.05 | 9/30/2021 | | C | | | 50000 | (3) | (3) | Units | 50000 | $1.25 | 0 | D | |
Warrants | $1.25 | 9/30/2021 | | C | | 50000 | | 9/30/2021 | 7/6/2024 | Common | 50000 | $1.25 | 50000 | D | |
Explanation of Responses: |
(1) | One third vest on each anniversary of the date of grant. |
(2) | 50% vest on March 31, 2022 and 50% vest on March 31, 2023. |
(3) | Each Subscription Receipt was automatically converted on September 30, 2021 into units of The Alkaline Water Company Inc. with each unit consisting of one common share and one common share purchase warrant, with each share purchase warrant entitling the holder to acquire one common share at $1.25 per share for a period ending on July 6, 2024. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
LAZARAN FRANK 6809 LAHONTAN DRIVE FORT WORTH, TX 76132 | X |
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Signatures
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/s/ Frank Lazaran | | 12/21/2021 |
**Signature of Reporting Person | Date |
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