0001213900-16-014446.txt : 20160623 0001213900-16-014446.hdr.sgml : 20160623 20160623142953 ACCESSION NUMBER: 0001213900-16-014446 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160621 FILED AS OF DATE: 20160623 DATE AS OF CHANGE: 20160623 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BioSolar Inc CENTRAL INDEX KEY: 0001371128 STANDARD INDUSTRIAL CLASSIFICATION: UNSUPPORTED PLASTICS FILM & SHEET [3081] IRS NUMBER: 000000000 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 27936 Lost Canyon Road STREET 2: Suite 202 CITY: Santa Clarita STATE: CA ZIP: 91387 BUSINESS PHONE: 6612510001 MAIL ADDRESS: STREET 1: 27936 Lost Canyon Road STREET 2: Suite 202 CITY: Santa Clarita STATE: CA ZIP: 91387 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEE DAVID DONGHIE CENTRAL INDEX KEY: 0001390620 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54819 FILM NUMBER: 161728384 MAIL ADDRESS: STREET 1: BIOSOLAR INC STREET 2: 27936 LOST CANYON ROAD SUITE 202 CITY: SANTA CLARITA STATE: CA ZIP: 91387 4 1 f4062116lee_biosolarinc.xml OWNERSHIP DOCUMENT X0306 4 2016-06-21 0 0001371128 BioSolar Inc BSRC 0001390620 LEE DAVID DONGHIE 27936 LOST CANYON ROAD, SUITE 202 SANTA CLARITA CA 91387 1 1 1 0 CEO, Acting CFO Common Stock 2016-06-21 4 J 0 330558 A 3453055 D Convertible Note 2016-06-21 4 J 0 330558 D 2013-06-05 2017-06-05 Common Stock 330558 0 D Common Stock was issued to Reporting person upon the conversion of $33,000 principal and $5,014.17 interest of a convertible promissory note granted to the Reporting Person by the Issuer pursuant to a Convertible Note Agreement dated June 5, 2013 which was issued directly to Reporting Person by the Issuer in satisfaction of unpaid salary. The balance of the Promissory Note was convertible into shares of the Issuer's common stock at a conversion price equal to the lesser of (i) $0.24 per share, or (ii) the closing prices of the Issuer's common stock on the last complete trading day immediately preceding the date of conversion. The original balance of the Promissory Note was $128,000. There is no longer a balance on this Promissory Note. /s/ David Lee 2016-06-23