SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
Shiff Dov

(Last) (First) (Middle)
C/O SQL TECHNOLOGIES CORP.
11030 JONES BRIDGE ROAD, SUITE 206

(Street)
JOHNS CREEK GA 30022

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/09/2022
3. Issuer Name and Ticker or Trading Symbol
SQL Technologies Corp. [ SKYX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock, no par value 1,255,000 D
Common Stock, no par value 10,779,618 I By Shiff Group(1)
Common Stock, no par value 40,000 I By Spouse
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) 01/01/2018 01/01/2023 Common Stock, no par value 25,000 $3 D
Stock Option (right to buy) 01/01/2019 01/01/2024 Common Stock, no par value 25,000 $3 D
Stock Option (right to buy) 01/01/2020 01/01/2025 Common Stock, no par value 25,000 $12 D
Stock Option (right to buy) 12/31/2020 12/31/2025 Common Stock, no par value 25,000 $12 D
Stock Option (right to buy) 12/31/2021 12/31/2026 Common Stock, no par value 25,000 $12 D
Series A Convertible Preferred Stock (2) (2) Common Stock, no par value 2,600,000 (2) I By Shiff Group(1)
6.0% Subordinated Convertible Promissory Note (3) 11/03/2023 Common Stock, no par value $600,000(4) $15 I By Shiff Group(1)
Explanation of Responses:
1. These securities are owned by Shiff Group Investments Ltd., of which the reporting person is an owner and the President and Chief Executive Officer.
2. The Series A Convertible Preferred Stock is convertible at any time, at the holder's election, on a one-for-one basis, and has no expiration date. In connection with the consummation of the issuer's initial public offering, Shiff Group Investments Ltd. has elected to convert all shares of Series A Convertible Preferred Stock held by it into shares of common stock.
3. The principal amount, plus any accrued and unpaid interest, is convertible at any time on or prior to the maturity date at the holder's discretion at the conversion price of $15.00.
4. Represents the principal amount of the convertible note and excludes interest that may accrue. Interest on the note is payable annually, in cash or common stock, at the holder's discretion.
/s/ Dov Shiff 02/09/2022
** 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 5 (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.
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