0001213900-21-004955.txt : 20210128 0001213900-21-004955.hdr.sgml : 20210128 20210128164652 ACCESSION NUMBER: 0001213900-21-004955 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210128 FILED AS OF DATE: 20210128 DATE AS OF CHANGE: 20210128 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Smith Christopher H CENTRAL INDEX KEY: 0001311438 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39924 FILM NUMBER: 21565844 MAIL ADDRESS: STREET 1: C/O ONEIDA LTD. STREET 2: 163-181 KENWOOD AVENUE CITY: ONEIDA STATE: NY ZIP: 13421 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Crown Electrokinetics Corp. CENTRAL INDEX KEY: 0001761696 STANDARD INDUSTRIAL CLASSIFICATION: ELECTRONIC COMPONENTS, NEC [3679] IRS NUMBER: 475423944 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 1110 NE CIRCLE BLVD CITY: CORVALLIS STATE: OR ZIP: 97330 BUSINESS PHONE: 800-674-3612 MAIL ADDRESS: STREET 1: 1110 NE CIRCLE BLVD CITY: CORVALLIS STATE: OR ZIP: 97330 3 1 ownership.xml OWNERSHIP DOCUMENT X0206 3 2021-01-28 0 0001761696 Crown Electrokinetics Corp. CRKN 0001311438 Smith Christopher H 225 CANNON COURT EAST PONTE VEDRA BEACH FL 32082 1 0 0 0 Common Stock 0 D Call Option 4.50 2030-12-01 Common Stock 33333 D Issued pursuant to the Issuer's 2016 Equity Incentive Plan. Options to purchase 33,333 shares of the Issuer's Common Stock, all of which have vested. /s/ Christopher Smith 2021-01-28