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*
Tan James Mengdong

(Last) (First) (Middle)
10 ANSON ROAD,
#35-11 INTERNATIONAL PLAZA

(Street)
SINGAPORE U0 079903

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/14/2013
3. Issuer Name and Ticker or Trading Symbol
Moxian, Inc. [ MOXC ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) X Other (specify below)
Former Pres., CEO and Director
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)
Common Stock 9,990,000 I By Good Eastern Investment Holding Limited (solely owned by Mr. Tan)
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
Explanation of Responses:
Remarks:
Mr. Tan was appointed as the director of MOXC on February 13, 2015 and was appointed as the CEO and President of MOXC on June 30, 2015. On September 28, 2017, Mr. Tan resigned from his positions as a director and from all officer positions with the Issuer and from all director and officer positions with the Issuer's subsidiaries, effective September 29, 2017. Mr. Tan is a member and director of Good Eastern Investment Holdings Limited ("Good Eastern"). On November 19, 2013, Good Eastern acquired 5,000 shares of MOXC in exchange for $0.10 per share. On November 22, 2013, Good Eastern acquired 661,000 shares of MOXC in exchange for $0.085 per share. On December 13, 2013 MOXC implemented a 60-for-1 forward stock split, causing the shares set forth above to be adjusted to 39,960,000 shares. On February 22, 2016, MOXC and Good Eastern agreed to a cancellation of shares that resulted in Good Eastern owning 19,980,000 shares of MOXC, and on June 20, 2016, the MOXC effected a 1 for 2 reverse stock split, which caused the shares MOXC held by Good Eastern to be adjusted to 9,990,000. See Exhibit 1 attached here for additional information.
/s/ James Mengdong Tan 02/28/2018
** 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.
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