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*
STROMMEN JACK B.

(Last) (First) (Middle)
7108 31ST AVENUE NORTH

(Street)
MINNEAPOLIS MN 55427

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/19/2017
3. Issuer Name and Ticker or Trading Symbol
BIOLARGO, INC. [ BLGO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
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
Common Stock Warrants (Right to Buy) 08/26/2015(1) 06/01/2026 Common Stock 1,400,000 $0.4 D
Common Stock Warrants (Right to Buy) 10/08/2015 06/01/2026 Common Stock 1,857,143 $0.45 D
Convertible Promissory Notes due 2018 08/26/2015(2) 06/01/2018 Common Stock 1,400,000 $0.25 D
Convertible Promissory Notes due 2018 10/08/2015 06/01/2018 Common Stock 1,857,143 $0.35 D
Explanation of Responses:
1. The Common Stock Warrants described are comprised of two separate Warrant grants, made on August 26, 2015 and September 9, 2015, respectively. Each such Common Stock Warrant includes identical terms and was immediately exercisable upon grant.
2. The Convertible Promissory Notes described are comprised of two Convertible Promissory Notes, issued on August 26, 2015 and September 9, 2015, respectively. Each such Convertible Promissory Note includes identical terms and was immediately convertible upon issuance.
/s/ Jack B. Strommen 06/28/2017
** 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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