0001422124-23-000004.txt : 20230526 0001422124-23-000004.hdr.sgml : 20230526 20230526214140 ACCESSION NUMBER: 0001422124-23-000004 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230228 FILED AS OF DATE: 20230526 DATE AS OF CHANGE: 20230526 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KILBOURNE THOMAS C CENTRAL INDEX KEY: 0001203486 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50107 FILM NUMBER: 23971222 MAIL ADDRESS: STREET 1: P O BOX A CITY: OSBURN STATE: ID ZIP: 83849 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DAYBREAK OIL & GAS, INC. CENTRAL INDEX KEY: 0001164256 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 910626366 STATE OF INCORPORATION: WA FISCAL YEAR END: 0228 BUSINESS ADDRESS: STREET 1: 1101 NORTH ARGONNE ROAD STREET 2: SUITE A 211 CITY: SPOKANE VALLEY STATE: WA ZIP: 99212 BUSINESS PHONE: (509) 232-7674 MAIL ADDRESS: STREET 1: 1101 NORTH ARGONNE ROAD STREET 2: SUITE A 211 CITY: SPOKANE VALLEY STATE: WA ZIP: 99212 FORMER COMPANY: FORMER CONFORMED NAME: Daybreak Oil & Gas, Inc. DATE OF NAME CHANGE: 20120712 FORMER COMPANY: FORMER CONFORMED NAME: DAYBREAK OIL & GAS INC DATE OF NAME CHANGE: 20051212 FORMER COMPANY: FORMER CONFORMED NAME: DAYBREAK MINES INC DATE OF NAME CHANGE: 20011231 5 1 primary_doc.xml PRIMARY DOCUMENT X0407 5 2023-02-28 0 0 0 0001164256 DAYBREAK OIL & GAS, INC. DBRM 0001203486 KILBOURNE THOMAS C P O BOX A OSBURN ID 83849 0 1 0 0 Asst. Corp. Secretary 0 Common Stock ($0.001 Par Value) 2022-02-22 5 A 0 L 585555 0.45 A 1512627 D This transaction was/is disclosed on the Issuer's SEC filings and its corporate website. Acquired pursuant to an agreement effective December 15, 2021, which called for conversion of debt into Daybreak common stock at a conversion price of $0.45 per share. Karol Adams for Thomas C Kilbourne by power of atty 2023-05-23