0001213900-23-025464.txt : 20230331
0001213900-23-025464.hdr.sgml : 20230331
20230331161023
ACCESSION NUMBER: 0001213900-23-025464
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200112
FILED AS OF DATE: 20230331
DATE AS OF CHANGE: 20230331
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CROXALL DOUGLAS B
CENTRAL INDEX KEY: 0001331155
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39924
FILM NUMBER: 23787691
MAIL ADDRESS:
STREET 1: 2331 MILL ROAD SUITE 100
CITY: ALEXANDRIA
STATE: VA
ZIP: 22314
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Crown Electrokinetics Corp.
CENTRAL INDEX KEY: 0001761696
STANDARD INDUSTRIAL CLASSIFICATION: ELECTRONIC COMPONENTS, NEC [3679]
IRS NUMBER: 475423944
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1110 NE CIRCLE BLVD
CITY: CORVALLIS
STATE: OR
ZIP: 97330
BUSINESS PHONE: 800-674-3612
MAIL ADDRESS:
STREET 1: 1110 NE CIRCLE BLVD
CITY: CORVALLIS
STATE: OR
ZIP: 97330
4
1
ownership.xml
OWNERSHIP DOCUMENT
X0407
4
2020-01-12
0
0001761696
Crown Electrokinetics Corp.
CRKN
0001331155
CROXALL DOUGLAS B
1110 NE CIRCLE BLVD
CORVALLIS
OR
97330
1
1
1
0
Chief Executive Officer
0
Common Stock
2020-01-12
2020-01-12
4
D
0
238095
0
D
2829448
I
See Footnote
Common Stock
2021-11-10
2021-11-10
4
S
0
1000000
0.90
D
1829448
I
See Footnote
Restricted Stock Units
2022-09-23
2022-09-23
4
A
0
150000
0
A
Common Stock
150000
150000
I
See Footnote
Options to Purchase Common Stock
0.34
2022-09-23
2022-09-23
4
A
0
150000
0
A
2032-09-23
Common Stock
150000
3365672
I
See Footnote
Reflects the forfeiture of certain incentive compensation for no consideration.
Share amount reflects 3-for-1 reverse stock split effected January 25, 2021.
Held through Croxall Family Revocable Trust dated February 20, 2004.
Each restricted stock unit represents a contingent right to receive one share of the Issuer's Common Stock.
Subject to the Reporting Person remaining in continuous service with the Issuer through each applicable vesting date, 4,166 of the restricted stock units will vest monthly for a period of 36 months, beginning September 23, 2022.
/s/ Douglas Croxall
2023-03-31