SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
HINSHAW MICHAEL

(Last) (First) (Middle)
201 SPEAR STREET
SUITE1100

(Street)
SAN FRANCISCO CA 94105

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
McorpCX, Inc. [ MCCX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
X Officer (give title below) Other (specify below)
President of McorpCX, LLC
3. Date of Earliest Transaction (Month/Day/Year)
09/03/2019
4. If Amendment, Date of Original Filed (Month/Day/Year)
09/17/2019
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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common stock 09/03/2019 S 0(1) D (1) 5,200,000 D
Common stock 09/03/2019 G 0(2) D (2) 5,200,000(3) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. The Form 4, as originally filed on September 17, 2019, reported two sales by the Reporting Person, each of 300,000 shares of common stock of McorpCX, Inc. The stock purchase agreements pursuant to which those shares of common stock were to be sold were terminated prior to the consummation of the sales of the shares subject to these agreements, and thus this amendment to the Form 4 removes the originally reported transactions.
2. The Form 4, as originally filed on September 17, 2019, reported the gifting of 250,000 shares of common stock of McorpCX, Inc. (incorrectly identified on such Form 4 as "Stock Options"). The gift agreement pursuant to which those shares of common stock were to be gifted by the Reporting Person to a third party was terminated prior to the consummation of the transfer of the shares of common stock subject to the gift agreement, and thus this amendment to the Form 4 removes the originally reported transaction.
3. Represents the number of shares beneficially owned by the Reporting Person as of the date of this amended Form 4.
/s/ Andrew J. Bond, Attorney in Fact for Michael Hinshaw 05/20/2020
** 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 4 (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).
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