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
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1. Name and Address of Reporting Person*
Calkins Jeffrey

(Last) (First) (Middle)
7303 30TH STREET S.E.

(Street)
CALGARY A0 T2C 1N6

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/08/2019
3. Issuer Name and Ticker or Trading Symbol
DIRTT ENVIRONMENTAL SOLUTIONS LTD [ DRTT ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
See Remarks
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)
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
Director and Employee Stock Option (right to buy) (1) 05/16/2024 Common Shares 99,767 $5.92(2) D
Explanation of Responses:
1. The option, representing a right to purchase a total of 99,767 shares, becomes exercisable as to 33,256 shares on May 17, 2020, with the remainder to vest in two equal annual installments thereafter, subject to continued service through each vesting date.
2. The exercise price of the option of CAD$7.84 is converted to USD based on the daily average exchange rate as reported by the H.10 statistical release of the Board of Governors of the Federal Reserve System on September 27, 2019 of C$1.3250 = US$1.00.
Remarks:
Senior Vice President, Chief Operating Officer. See attached for Exhibit 24 - Power of Attorney
/s/ Nandini Somayaji, as attorney-in-fact for Jeffrey A. Calkins 10/08/2019
** 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.