Statement of Changes in Beneficial Ownership (4)
January 07 2021 - 1:37PM
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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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
*
Hazout Marc |
2. Issuer Name and Ticker or Trading Symbol
SusGlobal Energy Corp.
[
SNRG
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Exec. Chairman, President, CEO |
(Last)
(First)
(Middle)
200 DAVENPORT ROAD |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/11/2020 |
(Street)
TORONTO, A6 M5R 1J2
(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, par value $0.0001 per share | 12/11/2020 | | A(1) | | 1516317 | A | $0.06 | 12416317 | I | Travellers International Inc. (2) |
Common Stock, par value $0.0001 per share | 12/17/2020 | | A(1) | | 780000 | A | $0.10 | 13196317 | I | Travellers International Inc. (2) |
Common Stock, par value $0.0001 per share | 12/22/2020 | | A(1) | | 117647 | A | $0.17 | 13313964 | I | Travellers International Inc. (2) |
Common Stock, par value $0.0001 per share | 12/31/2020 | | A(1) | | 771028 | A | $0.214 | 14084992 | I | Travellers International Inc. (2) |
Common Stock, par value $0.0001 per share | 1/4/2021 | | A(3) | | 1000000 | A | $0.00 | 15084992 | I | Travellers International Inc. (2) |
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) | The shares were issued as repayment of loans by Mr. Hazout to the Issuer. Mr. Hazout lent a total of $353,979 to the Issuer. |
(2) | Marc Hazout controls Travellers International Inc. |
(3) | The shares of common stock were issued to Mr. Hazout pursuant to the terms of the executive consulting agreement, by and between Mr. Hazout and the Issuer, dated January 1, 2021. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Hazout Marc 200 DAVENPORT ROAD TORONTO, A6 M5R 1J2 | X | X | Exec. Chairman, President, CEO |
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Signatures
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/s/ Marc Hazout | | 1/7/2021 |
**Signature of Reporting Person | Date |
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