0001454170-18-000005.txt : 20180606 0001454170-18-000005.hdr.sgml : 20180606 20180606160402 ACCESSION NUMBER: 0001454170-18-000005 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180605 FILED AS OF DATE: 20180606 DATE AS OF CHANGE: 20180606 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Clay Thomas Moragne CENTRAL INDEX KEY: 0001454170 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21777 FILM NUMBER: 18883854 MAIL ADDRESS: STREET 1: C/O EAST HILL MANAGEMENT COMPANY, LLC STREET 2: 70 MAIN STREET, SUITE 300 CITY: PETERBOROUGH STATE: NH ZIP: 03458 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GOLDEN QUEEN MINING CO LTD CENTRAL INDEX KEY: 0001025362 STANDARD INDUSTRIAL CLASSIFICATION: METAL MINING [1000] IRS NUMBER: 000000000 STATE OF INCORPORATION: A1 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: GOLDEN QUEEN MINING CO. LTD. STREET 2: #2300 - 1066 WEST HASTINGS STREET CITY: VANCOUVER STATE: A1 ZIP: V6E 3X2 BUSINESS PHONE: 604-921-7570 MAIL ADDRESS: STREET 1: GOLDEN QUEEN MINING CO. LTD. STREET 2: #2300 - 1066 WEST HASTINGS STREET CITY: VANCOUVER STATE: A1 ZIP: V6E 3X2 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2018-06-05 0 0001025362 GOLDEN QUEEN MINING CO LTD GQM 0001454170 Clay Thomas Moragne C/O EAST HILL MANAGEMENT COMPANY, LLC 70 MAIN STREET, SUITE 300 PETERBOROUGH NH 03458 1 1 0 0 CEO Common Stock 6658116 D Common Stock 2018-06-05 4 J 0 248082 0 D 0 I By Corporation Common Stock 7031755 I By trust Common Stock 807250 I By trust Represents shares of common stock of Golden Queen Mining Co. Ltd. (the "Issuer") held by LTC Corporation ("LTC Corp"). The Estate of Landon Thomas Clay (the "Estate") is the sole stockholder of LTC Corp following the death of Mr. Landon Thomas Clay, the Reporting Person's father, in July 2017. The Reporting Person is the executor of the Estate and the president of LTC Corp. On June 4, 2018, LTC Corp distributed all of its shares of common stock of the Issuer to the Estate. Following this disposition the Reporting Person no longer holds any beneficial interest in these shares of common stock of the Issuer. Represents shares of common stock of the Issuer held by the Monadnock Charitable Lead Annuity Trust dated May 31, 1996 ("Monadnock"). East Hill Management Company, LLC ("East Hill") provides investment advisory services to Monadnock. The Reporting Person is the sole manager of East Hill. Mr. Landon Thomas Clay was the donor of the assets to Monadnock and the Reporting Person has a remainder beneficial interest in the assets held by Monadnock. The Reporting Person disclaims beneficial ownership of the shares of common stock of the Issuer held by Monadnock except to the extent of the Reporting Person's proportionate pecuniary interest therein. Represents common shares of the Issuer held by Arctic Coast Petroleums, Ltd. ("Arctic Coast"). The Reporting Person is a trustee of the Clay Family 2009 Irrevocable Trust dated April 14, 2009 (the "2009 Trust"), which owns 50% of the equity interests of Arctic Coast. Mr. Landon Thomas Clay was the donor of the portion of Arctic Coast held by the 2009 Trust. The Reporting Person is a director of Arctic Coast. The Reporting Person disclaims beneficial ownership of 50% of the shares of Common Stock held by Arctic Coast. /s/ Thomas M. Clay 2018-06-06