SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
ANDREASSEN LASSE

(Last) (First) (Middle)
INDUSTRIPARKEN 22

(Street)
BALLERUP G7 2750

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
LIQTECH INTERNATIONAL INC [ LIQT ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
08/24/2011
4. If Amendment, Date of Original Filed (Month/Day/Year)
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. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction 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)
Code V Amount (A) or (D) Price
Common Stock 10/07/2013 M 25,000 A $1.5 2,741,888 I(1) See footnote(1)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction 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 (Month/Day/Year) 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: 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 $1.5 08/24/2011 A 60,000 (2) 02/28/2015 Common stock 60,000 $1.5 60,000 D
Stock options $3 08/24/2011 A 180,000 (3) 02/28/2015 Common Stock 180,000 $3 240,000 D
Stock options $3.28 03/23/2012 A 97,332 (4) 02/22/2015 Common stock 97,332 $3.28 337,332 D
Stock options $1.5 10/07/2013 D 25,000 (2) 02/28/2015 Common Stock 25,000 $1.5 312,332 D
Stock option $2.7 10/07/2013 A 25,000 10/07/2013 02/28/2015 Common stock 25,000 $2.7 337,332 D
Explanation of Responses:
1. Shares of common stock are owned by El Salto ApS, a Danish entity. The voting and disposition of the shares owned by El Salto is controlled by Mr. Andreassen. Also include direct ownership of the vested portion of 337,332 stock options, of which 25,000 stock options have an exercise price of $2.70 and are fully vested, 35,000 stock options have an exercise price of $1.50 per share and are fully vested, 180,000 stock options have an exercise price of $3.00 and are fully vested and 97,332 stock options have an exercise price of $3.28 and vest in three equal annual installments on March 23, 2012, March 23, 2013 and March 23, 2014.
2. The 60,000 stock options had an exercise price of $1.50 and vested (and were also exercisable) in three equal annual installments on August 24, 2011, September 1, 2012 and September 1, 2013.
3. The 180,000 stock options have an exercise price of $3.00 and vested (and were also exercisable) in three equal annual installments on August 24, 2011, September 1, 2012 and September 1, 2013.
4. The 97,332 stock options have an exercise price of $3.28 and vest (and are also exercisable) in three equal installments on March 23, 2012, March 23, 2013 and March 23, 2014.
/s/ Lasse Andreassen 10/10/2013
** 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 Number.