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SGLB Sigma Labs Inc

1.05
0.00 (0.00%)
03 May 2024 - Closed
Delayed by 15 minutes
Share Name Share Symbol Market Type
Sigma Labs Inc NASDAQ:SGLB NASDAQ Common Stock
  Price Change % Change Share Price Bid Price Offer Price High Price Low Price Open Price Shares Traded Last Trade
  0.00 0.00% 1.05 1.03 1.07 0 01:00:00

Annual Statement of Changes in Beneficial Ownership (5)

11/02/2021 9:47pm

Edgar (US Regulatory)


FORM 5
[X] 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 *

Schwartz Carl I.
2. Issuer Name and Ticker or Trading Symbol

SIGMA LABS, INC. [SGLB]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

_____ Director                    _____ 10% Owner
_____ Officer (give title below)    __X__ Other (specify below)
Former 10% holder
(Last)          (First)          (Middle)

3750 LAS VEGAS BLVD. SOUTH,  APT. 4303
3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY)
12/31/2020 
(Street)

LAS VEGAS, NV 89158
(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. Date2A. Deemed Execution Date, if any3. 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        200000 (1)D  
Common Stock        40000 (1)I By Carl I. Schwartz Revocable Family Trust dtd 3/14/19 

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 Security3. Trans. Date3A. Deemed Execution Date, if any4. 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 ExercisableExpiration DateTitleAmount or Number of Shares
Series E Convertible Preferred Stock $10.30 (4)1/28/2020  P4  266.67    1/28/2020  (2)Common Stock 38835 (1)$1500 266.67 I By Carl & Shirley Schwartz Trust 
Warrants to Purchase Common Stock $11.13 (4)1/28/2020  P4  38835    7/26/2020 7/26/2025 Common Stock 38835 (1) (3)38835 (1)I By Carl & Shirley Schwartz Trust 

Explanation of Responses:
(1) Share ownership totals have been adjusted to reflect a 1 for 10 reverse stock split effected by the issuer on February 27, 2020.
(2) No expiration date.
(3) Purchase was made in conjunction with purchase of Series E Convertible Preferred Stock.
(4) Conversion and exercise prices have been adjusted to reflect a 1 for 10 reverse stock split effected by the issuer on February 27, 2020.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
Schwartz Carl I.
3750 LAS VEGAS BLVD. SOUTH
APT. 4303
LAS VEGAS, NV 89158



Former 10% holder

Signatures
/s/ Carl I. Schwartz, DDS2/9/2021
**Signature of Reporting PersonDate

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