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
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Sheeran Gerald Anthony

(Last) (First) (Middle)
C/O SG BLOCKS, INC.
195 MONTAGUE STREET, 14TH FLOOR

(Street)
BROOKLYN NY 11201

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/22/2019
3. Issuer Name and Ticker or Trading Symbol
SG BLOCKS, INC. [ SGBX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
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 8,333(1) D
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) (2) 03/30/2028 Common Stock 25,000 $4.61 D
Explanation of Responses:
1. Represents a grant of restricted stock units ("RSUs") under the SG Blocks, Inc. Stock Incentive Plan. Each RSU represents the right to receive, upon vesting, one share of the issuer's common stock, par value $0.01. The RSUs will vest in full on December 31, 2019, subject to the reporting person's continued service as an employee of the issuer through such date, and are deliverable January 1, 2020.
2. The stock option was granted on March 30, 2018 and shall vest and become exercisable in twelve equal quarterly installments over a three-year period, beginning on June 30, 2018.
/s/ Gerald Sheeran 08/30/2019
** 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.
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.