Statement of Changes in Beneficial Ownership (4)
June 06 2023 - 5:19PM
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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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
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KNOWLES MICHAEL |
2. Issuer Name and Ticker or Trading Symbol
ONE STOP SYSTEMS, INC.
[
OSS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chief Executive Officer |
(Last)
(First)
(Middle)
2235 ENTERPRISE STREET, SUITE 110 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/5/2023 |
(Street)
ESCONDIDO, CA 92029 |
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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(City)
(State)
(Zip)
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Rule 10b5-1(c) Transaction Indication
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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to
satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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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 | 6/5/2023 | | A | | 400000 (1) | A | $0.00 | 400000 (2) | 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 Option (right to buy) | $2.94 | 6/5/2023 | | A | | 400000 (3) | | (4) | 6/4/2033 | Common Stock | 400000 | $0.00 | 400000 | D | |
Explanation of Responses: |
(1) | Represents 400,000 restricted stock units granted to the Reporting Person outside of the Issuer's 2017 Equity Incentive Plan, as amended (the "Plan"), in connection with, and as a material inducement to, the hiring and appointment of the Reporting Person as President and Chief Executive Officer of the Issuer, which restricted stock units are subject to vesting conditions. |
(2) | Consists of 400,000 unvested restricted stock units held by the Reporting Person, all of which remain subject to certain vesting conditions. |
(3) | Represents non-qualified stock options to purchase 400,000 shares of of the Issuer's common stock, which stock options were granted to the Reporting Person outside of the Issuer's Plan, in connection with, and as a material inducement to, the hiring and appointment of the Reporting Person as President and Chief Executive Officer of the Issuer. |
(4) | The stock options vest shall vest over four years, with one fourth vesting on the one-year anniversary of the date of grant and the remaining stock options vesting in six equal installments, commencing six months after the one-year anniversary of the grant date and every six months thereafter until fully vested. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
KNOWLES MICHAEL 2235 ENTERPRISE STREET, SUITE 110 ESCONDIDO, CA 92029 |
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| Chief Executive Officer |
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Signatures
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/s/ Michael Knowles | | 6/6/2023 |
**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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