0001493152-21-008590.txt : 20210412 0001493152-21-008590.hdr.sgml : 20210412 20210412211423 ACCESSION NUMBER: 0001493152-21-008590 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210408 FILED AS OF DATE: 20210412 DATE AS OF CHANGE: 20210412 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Nissensohn Carlos Jaime CENTRAL INDEX KEY: 0001745012 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-09047 FILM NUMBER: 21821826 MAIL ADDRESS: STREET 1: TRAVESA DE PRAIA 128 CITY: PRAIA DA LUZ STATE: S1 ZIP: 8600 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: OMNIQ Corp. CENTRAL INDEX KEY: 0000278165 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 020314487 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1865 WEST 2100 SOUTH CITY: SALT LAKE CITY STATE: UT ZIP: 84119 BUSINESS PHONE: 800-242-7272 MAIL ADDRESS: STREET 1: 1865 WEST 2100 SOUTH CITY: SALT LAKE CITY STATE: UT ZIP: 84119 FORMER COMPANY: FORMER CONFORMED NAME: Quest Solution, Inc. DATE OF NAME CHANGE: 20140813 FORMER COMPANY: FORMER CONFORMED NAME: AMERIGO ENERGY, INC. DATE OF NAME CHANGE: 20081112 FORMER COMPANY: FORMER CONFORMED NAME: STRATEGIC GAMING INVESTMENTS, INC. DATE OF NAME CHANGE: 20060501 4 1 ownership.xml X0306 4 2021-04-08 0 0000278165 OMNIQ Corp. OMQS 0001745012 Nissensohn Carlos Jaime C/O OMNIQ CORP. 1865 WEST 2100 SOUTH SALT LAKE CITY, UT 84119 0 0 1 0 Common Stock 2021-04-08 2021-04-08 4 M 0 57026 2.20 A 786334 I See Footnote Warrants 2.20 2021-04-08 4 M 0 75000 D 2021-08-02 Common Stock 75000 0 D The warrants exercised herein reflect the cashless exercise of certain warrants scheduled to expire on August 2, 2021. In connection with a Consulting Agreement, 1,500,000 warrants were granted to Mr. Nissensohn on August 2, 2017. Following the Company's 1-for-20 reverse stock split of its common stock, effective, November 20, 2019, the number of warrants to be exercised is 75,000. Following the net exercise, Mr. Nissensohn has no more options from the August 2017 grant. Upon exercise, the underlying net warrants convert into shares of the issuer's common stock on a one-for-one basis, after giving effect to the 20:1 reverse stock split. Prior to the transaction reported herein, 729,308 shares of the issuer's common shares were held by Campbeltown Consulting Ltd., which is beneficially owned by Mr. Nissensohn. /s/ Carlos Jaime Nissensohn 2021-04-12