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
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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*
CLAY LANDON T

(Last) (First) (Middle)
C/O EAST HILL MANAGEMENT CO., LLC
10 MEMORIAL BLVD, SUITE 902

(Street)
PROVIDENCE RI 02903

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
GOLDEN QUEEN MINING CO LTD [ GQM ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
03/21/2013
4. If Amendment, Date of Original Filed (Month/Day/Year)
03/25/2013
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 03/21/2013 J 1,557,617(1) D $2.05 0 I By grantor retained annuity trust
Common Stock 03/21/2013 J 1,557,617(1) A $2.05 3,524,268 D
Common Stock 03/21/2013 J 3,362,241(2) D $2.05 0 I By grantor retained annuity trust
Common Stock 03/21/2013 J 3,362,241(2) A $2.05 6,886,509 D
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
Explanation of Responses:
1. The Insider is the Grantor of the Landon T. Clay 2011-2 Annuity Trust (the "2011-2 GRAT"). As Grantor, the Insider exercised his right to substitute property of equivalent value for the shares held in the 2011-2 GRAT. The ownership of the shares held by the 2011-2 GRAT as reported by the Insider was changed from indirect to direct ownership upon the exericse of the right of subtitution.
2. The Insider is the Grantor of the Landon T. Clay 2012-1 Annuity Trust (the "2012-1 GRAT"). As Grantor, the Insider exercised his right to substitute property of equivalent value for the shares held by the 2012-1 GRAT. The ownership of the shares held by the 2012-1 GRAT as reported by the Insider was changed from indirect to direct ownership upon exercise of the right of substitution.
/s/ Landon T. Clay 04/29/2013
** 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).
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