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*
Eisler Jesse Grant

(Last) (First) (Middle)
C/O ARCIMOTO, INC.
2034 WEST 2ND AVENUE

(Street)
EUGENE OR 97402

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Arcimoto Inc [ FUV ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
08/14/2019
4. 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 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
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
2019 Short-term Notes $4.25 08/14/2019 J 12,517(1)(2)(3) (1)(2)(3) (1)(2)(3) Common Stock 12,517(1)(2)(3) $4.25 0 D
Convertible Promissory Notes $4.25 08/14/2019 J 12,517(1)(2)(3) (1)(2)(3) (1)(2)(3) Common Stock 12,517(1)(2)(3) $4.25 12,517(1)(2)(3) D
Convertible Promissory Notes $4.25 08/15/2019 J 23,529(1)(2)(3) (1)(2)(3) (1)(2)(3) Common Stock 23,529(1)(2)(3) $4.25 23,529(1)(2)(3) D
Explanation of Responses:
1. The number of shares of Issuer's common stock was calculated based upon the dollar amounts of either principal or interest divided by the per share price of $4.25. The principal amount of the 2019 Short-term Notes, together with interest accrued thereon was payable, at the option of the holder, in (a) cash, (b) Issuer's common stock (valued at a price of $4.25 per share) or (c) in the event Issuer issued convertible promissory notes to third parties before the original maturity date (two months after the issuance), in a convertible promissory note on the same terms as purchased by such third parties.
2. On August 14, 2019, the principal ($50,000, representing 11,765 shares) and accrued interest ($3197.97, representing 752 shares) on the 2019 Short-term Notes were exchanged for $53,197.97 (representing 12,517 shares) in principal amount of convertible promissory notes. In addition, on August 15, 2019, the reporting person acquired an additional $100,000 principal amount of convertible promissory notes (representing an additional 23,529 shares). The principal amount of the convertible promissory notes is due and payable on August 14 and 15, 2020, respectively,
3. in (a) cash or (b) Issuer's common stock at a price of $4.25 per share, at the election of the holder of the convertible promissory notes. Interest on the convertible promissory notes accrues at an annual rate of 10%, compounded monthly.
/s/ W. David Mannheim, by Power of Attorney 08/16/2019
** 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 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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