Annual Statement of Changes in Beneficial Ownership (5)
04 Noviembre 2020 - 4:02PM
Edgar (US Regulatory)
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
[ ]
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
|
OMB APPROVAL
OMB Number:
3235-0362
Estimated average burden hours per response...
1.0
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
1. Name and Address of Reporting Person
*
GORODNITSKY IGOR | 2. Issuer Name and Ticker or Trading SymbolCavitation Technologies, Inc. [CVAT] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) President |
(Last)
(First)
(Middle)
10019 CANOGA AVENUE | 3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY) 6/30/2020 |
(Street)
CHATSWORTH, CA 91311
(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
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
|
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 | 8/28/2014 | | J4 (1) | 8000000 | D | $0 (1) | 9323475 | D | |
Common Stock | 4/4/2018 | | J4 (2) | 4323475 | D | $0 (2) | 5000000 | D | |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
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 |
Warrants | $0.03 | 5/13/2013 | | A4
| 2000000 | | 5/13/2013 | 5/13/2023 | Common Stock | 2000000 | (3) | 6250000 | D | |
Warrants | $0.045 | 10/10/2013 | | A4
| 3000000 | | 10/10/2013 | 10/10/2023 | Common Stock | 3000000 | (3) | 9250000 | D | |
Warrants | $0.03 | 1/13/2017 | | A4
| 3000000 | | 1/13/2017 | 1/13/2027 | Common Stock | 3000000 | (3) | 12250000 | D | |
Warrants | $0.03 | 12/26/2019 | | A4
| 3000000 | | 12/26/2019 | 12/26/2029 | Common Stock | 3000000 | (3) | 15250000 | D | |
Warrants | $0.045 | 5/18/2020 | | D4
| | 3000000 | 10/10/2013 | 10/10/2023 | Common Stock | 3000000 | (4) | 12250000 | D | |
Warrants | $0.03 | 5/18/2020 | | D4
| | 4250000 | 12/18/2012 | 12/18/2022 | Common Stock | 4250000 | (4) | 8000000 | D | |
Warrants | $0.03 | 5/18/2020 | | D4
| | 2000000 | 5/13/2013 | 5/13/2023 | Common Stock | 2000000 | (4) | 6000000 | D | |
Warrants | $0.045 | 5/18/2020 | | A4
| 3000000 | | 5/18/2020 | 5/18/2030 | Common Stock | 3000000 | (3) | 9000000 | D | |
Warrants | $0.03 | 5/18/2020 | | A4
| 6250000 | | 5/18/2020 | 5/18/2030 | Common Stock | 6250000 | (3) | 15250000 | D | |
Explanation of Responses: |
(1) | Reporting Person transferred these shares to his ex-wife as part of a divorce settlement; there was no money received. |
(2) | Reporting Person gifted these shares to his daughter; there was no money received. |
(3) | Reporting Person acquired Issuer's warrants as part of compensation for Reporting Person's employment at Issuer. |
(4) | These warrants were cancelled by the Company. |
Reporting Owners
|
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
GORODNITSKY IGOR 10019 CANOGA AVENUE CHATSWORTH, CA 91311 | X |
| President |
|
Signatures
|
/s/ Igor Gorodnitsky | | 11/4/2020 |
**Signature of Reporting Person | Date |
Cavitation Technologies (QB) (USOTC:CVAT)
Gráfica de Acción Histórica
De Ago 2024 a Sep 2024
Cavitation Technologies (QB) (USOTC:CVAT)
Gráfica de Acción Histórica
De Sep 2023 a Sep 2024