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*
Salkind Gene

(Last) (First) (Middle)
35 TORRINGTON LANE

(Street)
SHOREHAM NY 11766

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Mobiquity Technologies, Inc. [ MOBQ ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
09/30/2021
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
Common Stock(2) 09/30/2021 M 375,000 A (1) 1,116,021 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
Preferred Stock(2) (1) 09/30/2021 M 1,500(3) 12/04/2018 09/30/2021 Common stock 750,000(4) (5) 1,012,500(6) D
Common Stock Purchase Warrants(2) $48 09/30/2021 M 375,000 09/30/2021 09/20/2023 Common Stock 375,000 (5) 1,387,500 D
Explanation of Responses:
1. Not applicable - reporting person converted oneshare of Series C preferred stock into 250 common shares and 250 warrants,exercisable at $48 per share.
2. Includes securities or derivative securities heldboth jointly with his spouse and in trust.
3. Represents 1,500 shares of Series C preferredstock converted into 375,000 shares of common stock and a like number ofwarrants, exercisable at $48 per share through September 20, 2023.
4. Includes 375,000 common shares and 375,000warrants, exercisable at $48 per share through September 20, 2023.
5. None.
6. Includes 675,000 shares underlying $2.7million of debt convertible at $4 per share, with 50% warrant coverage (i.e. 337,500 warrants). The warrants are exercisable at $4per share through September 30, 2029, if and when, issued.The foregoing numbers exclude interest payable on the debt, which can also beconverted on the same basis.
/s/ Gene Salkind 10/04/2021
** 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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