Annual Statement of Changes in Beneficial Ownership (5)
04 Abril 2022 - 5:09PM
Edgar (US Regulatory)
FORM 5
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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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Form 3 Holdings Reported
[X]
Form 4 Transactions Reported |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0362
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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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Gu Jennifer Lingjie | 2. Issuer Name and Ticker or Trading SymbolFOCUS UNIVERSAL INC. [FCUV] |
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)
C/O FOCUS UNIVERSAL INC., 2311 EAST LOCUST STREET | 3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY) 12/31/2021 |
(Street)
ONTARIO, CA 91761
(City)
(State)
(Zip)
| 4. If Amendment, Date Original Filed(MM/DD/YYYY) | 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) | 2. Trans. Date | 2A. Deemed Execution Date, if any | 3. Trans. Code (Instr. 8) | 4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) |
Amount | (A) or (D) | Price |
Common Stock | 1/7/2021 | | G4 | 142800 | D | (1) | 7457200 | I | By Spouse |
Common Stock | 1/7/2021 | | G4 | 142800 | A | (1) | 142800 | I | See Footnote (1) |
Common Stock | 2/1/2021 | | G4 | 125000 | D | (2) | 7332200 | I | By Spouse |
Common Stock | 2/1/2021 | | G4 | 125000 | A | (2) | 267800 | I | See Footnote (2) |
Common Stock | 2/4/2021 | | G4 | 125000 | D | (3) | 7207200 | I | By Spouse |
Common Stock | 2/4/2021 | | G4 | 125000 | A | (3) | 392800 | I | See Footnote (3) |
Common Stock | 2/10/2021 | | G4 | 125000 | D | (4) | 7082200 | I | By Spouse |
Common Stock | 2/10/2021 | | G4 | 125000 | A | (4) | 517800 | I | See Footnote (4) |
Common Stock | 2/10/2021 | | G4 | 125000 | D | (5) | 6957200 | I | By Spouse |
Common Stock | 2/10/2021 | | G4 | 125000 | A | (5) | 125000 | I | See Footnote (5) |
Common Stock | 2/10/2021 | | G4 | 125000 | D | (6) | 6832200 | I | By Spouse |
Common Stock | 2/10/2021 | | G4 | 125000 | A | (6) | 125000 | I | See Footnote (6) |
Common Stock | 3/1/2021 | | G4 | 250000 | D | (7) | 6582200 | I | By Spouse |
Common Stock | 3/1/2021 | | G4 | 250000 | A | (7) | 375000 | I | See Footnote (7) |
Common Stock | 3/1/2021 | | G4 | 250000 | D | (8) | 6332200 | I | By Spouse |
Common Stock | 3/1/2021 | | G4 | 250000 | A | (8) | 375000 | I | See Footnote (8) |
Common Stock | 3/3/2021 | | G4 | 375000 | D | (9) | 5957200 | I | By Spouse |
Common Stock | 3/3/2021 | | G4 | 375000 | A | (9) | 892800 | I | See Footnote (9) |
Common Stock | 12/29/2021 | | G4 | 245000 | D | (10) | 5712200 | I | By Spouse |
Common Stock | 12/29/2021 | | G4 | 245000 | A | (10) | 1137800 | I | See Footnote (10) |
Common Stock | 12/29/2021 | | G4 | 70000 | D | (11) | 689000 | I | See Footnote (11) |
Common Stock | 12/29/2021 | | G4 | 13000 | D | (12) | 676000 | I | See Footnote (12) |
Table II - Derivative Securities Acquired, Disposed of, or 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 (MM/DD/YYYY) | 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 at End of Issuer's Fiscal Year (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
(1) | Edward Lee, the Reporting Person's spouse, transferred 142,800 shares of the Issuer's Common Stock to himself and the Reporting Person as trustees of the Lee-Gu Foundation. |
(2) | Edward Lee, the Reporting Person's spouse, transferred 125,000 shares of the Issuer's Common Stock to himself and the Reporting Person as trustees of the Lee-Gu Foundation. |
(3) | Edward Lee, the Reporting Person's spouse, transferred 125,000 shares of the Issuer's Common Stock to himself and the Reporting Person as trustees of the Lee-Gu Foundation. |
(4) | Edward Lee, the Reporting Person's spouse, transferred 125,000 shares of the Issuer's Common Stock to himself and the Reporting Person as trustees of the Lee-Gu Foundation. |
(5) | Edward Lee, the Reporting Person's spouse, transferred 125,000 shares of the Issuer's Common Stock to the Brandon Lee Irrevocable Trust, the beneficiary of which is the Reporting Person's child. The Reporting Person may be deemed to have indirect beneficial ownership of these 125,000 shares of the Issuer's Common Stock through her child. |
(6) | Edward Lee, the Reporting Person's spouse, transferred 125,000 shares of the Issuer's Common Stock to the Isabella Lee Irrevocable Trust, the beneficiary of which is the Reporting Person's child. The Reporting Person may be deemed to have indirect beneficial ownership of these 125,000 shares of the Issuer's Common Stock through her child. |
(7) | Edward Lee, the Reporting Person's spouse, transferred 250,000 shares of the Issuer's Common Stock to the Brandon Lee Irrevocable Trust, the beneficiary of which is the Reporting Person's child. The Reporting Person may be deemed to have indirect beneficial ownership of these 250,000 shares of the Issuer's Common Stock through her child. |
(8) | Edward Lee, the Reporting Person's spouse, transferred 250,000 shares of the Issuer's Common Stock to the Isabella Lee Irrevocable Trust, the beneficiary of which is the Reporting Person's child. The Reporting Person may be deemed to have indirect beneficial ownership of these 250,000 shares of the Issuer's Common Stock through her child. |
(9) | Edward Lee, the Reporting Person's spouse, transferred 375,000 shares of the Issuer's Common Stock to himself and the Reporting Person as trustees of the Lee-Gu Foundation. |
(10) | Edward Lee, the Reporting Person's spouse, transferred 245,000 shares of the Issuer's Common Stock to himself and the Reporting Person as trustees of the Lee-Gu Foundation. |
(11) | The Reporting Person and Edward Lee, the Reporting Person's spouse, as trustees of the Lee-Gu Family Foundation, donated 70,000 shares of the Issuer's Common Stock to the Asian Pacific Community Fund. |
(12) | The Reporting Person and Edward Lee, the Reporting Person's spouse, as trustees of the Lee-Gu Family Foundation, donated 13,000 shares of the Issuer's Common Stock to the First Evangelical Church of Diamond Bar. |
Remarks: Edward Lee, the Reporting Person's spouse, made these transactions for estate planning purposes; however, he could only medallion signature guarantee certain amounts of shares per week, which is why there are multiple transactions. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Gu Jennifer Lingjie C/O FOCUS UNIVERSAL INC. 2311 EAST LOCUST STREET ONTARIO, CA 91761 | X | X |
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Signatures
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/s/ Gilbert J. Bradshaw, Attorney-in-Fact for Jennifer Gu | | 4/4/2022 |
**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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