Statement of Changes in Beneficial Ownership (4)
20 July 2022 - 1:08AM
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).
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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
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Bremer John A |
2. Issuer Name and Ticker or Trading Symbol
PureBase Corp
[
PUBC
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
1660 CHICAGO AVENUE, SUITE M-11 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/4/2016 |
(Street)
RIVERSIDE, CA 92507
(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 | 3/4/2016 | 3/4/2016 | J(1) | | 40105500 | D | (1) | 0 | D | |
Common stock | 4/24/2019 | 4/24/2019 | P | | 10000 | A | $0.0650 | 10000 | D | |
Common stock | 7/24/2019 | 7/24/2019 | P | | 51785 | A | $0.0550 | 61785 | D | |
Common stock | 7/25/2019 | 7/25/2019 | P | | 15000 | A | $0.0785 | 76785 | D | |
Common stock | 2/12/2020 | 2/12/2020 | P | | 10000 | A | $0.20 | 86785 | D | |
Common stock | 4/24/2020 | 4/24/2020 | P | | 10000 | A | $0.1050 | 96785 | D | |
Common stock | 10/21/2020 | 10/21/2020 | P | | 9500 | A | $0.0850 | 106285 | D | |
Common stock | 10/29/2020 | 10/29/2020 | P | | 10000 | A | $0.0860 | 116285 | D | |
Common stock | 11/2/2020 | 11/2/2020 | P | | 9000 | A | $0.0800 | 125285 | D | |
Common stock | 4/18/2016 | 4/18/2016 | J(2) | | 57500 | D | (2) | 0 | I | By wife |
Common stock | 3/4/2016 | 3/4/2016 | J(1) | | 40105500 | A | (1) | 40105500 | I | By Trust |
Common stock | 4/18/2016 | 4/18/2016 | J(2) | | 57500 | A | (2) | 40163000 | I | By Trust |
Common stock | 9/5/2019 | 9/5/2019 | J(3) | | 60248484 | A | $0.09 | 60248484 | I | By Corporation |
Common stock | 2/3/2020 | 2/3/2020 | J(3) | | 6290094 | A | $0.09 | 66538578 | I | By Corporation |
Common stock | 7/7/2022 | 7/7/2022 | J(3) | | 6720905 | A | $0.16 | 73259483 | I | By Corporation |
Common stock | 7/7/2022 | 7/7/2022 | J(3) | | 17020749 | A | $0.088 | 90280232 | I | By Corporation |
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) | Represents the transfer of shares held by the Reporting Person to the Bremer Family 1995 Living Family Trust of which the Reporting person is a trustee. |
(2) | Represents the transfer of shares held by the Reporting Person's wife to the Bremer Family 1995 Living Family Trust of which the Reporting person is a trustee. |
(3) | Represents shares held by US Mine Corporation, of which the Reporting Person is a 33.3% owner. The Reporting Person disclaims beneficial ownership as to 66.6% of such shares. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Bremer John A 1660 CHICAGO AVENUE, SUITE M-11 RIVERSIDE, CA 92507 | X | X |
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Signatures
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/s/ John Bremer | | 7/19/2022 |
**Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
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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