Statement of Changes in Beneficial Ownership (4)
13 Aprile 2020 - 11:32PM
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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3235-0287
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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
*
Willkomm Wayne |
2. Issuer Name and Ticker or Trading Symbol
Lifeloc Technologies, Inc
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LCTC
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) CEO and President |
(Last)
(First)
(Middle)
12441 W. 49TH AVENUE, UNIT 4 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/1/2020 |
(Street)
WHEAT RIDGE, CO 80033
(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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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 (Right to Buy) | $6.00 | | | | | | | (1) | 10/1/2027 | Common Stock | 50000 | | 50000 | D | |
Stock Options (Right to Buy) | $3.80 | 3/1/2020 | | A | | 37500 | | 3/1/2020 | 3/1/2025 | Common Stock | 37500 | $0.00 | 50000 (2) | D | |
Explanation of Responses: |
(1) | The stock options were granted under the issuer's 2013 Stock Option Plan, and are subject to performance-based vesting based on the achievement of certain performance conditions set forth in the amended and restated employment agreement between the issuer and the reporting person. Of the 50,000 stock options granted, 25,000 expired without vesting 12/31/19 and 12,500 expired without vesting on 3/31/20. |
(2) | This total reflects 37,500 vested stock options pursuant to the 3/1/20 grant and 12,500 unvested stock options pursuant to the 10/1/17 grant. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Willkomm Wayne 12441 W. 49TH AVENUE, UNIT 4 WHEAT RIDGE, CO 80033 | X |
| CEO and President |
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Signatures
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/s/ Wayne Willkomm | | 4/10/2020 |
**Signature of Reporting Person | Date |
Grafico Azioni Lifeloc Technologies (PK) (USOTC:LCTC)
Storico
Da Mar 2025 a Mar 2025
Grafico Azioni Lifeloc Technologies (PK) (USOTC:LCTC)
Storico
Da Mar 2024 a Mar 2025
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