0001209191-21-048215.txt : 20210726 0001209191-21-048215.hdr.sgml : 20210726 20210726173425 ACCESSION NUMBER: 0001209191-21-048215 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210722 FILED AS OF DATE: 20210726 DATE AS OF CHANGE: 20210726 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Harrison Jack CENTRAL INDEX KEY: 0001729604 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38371 FILM NUMBER: 211115124 MAIL ADDRESS: STREET 1: 2235 ENTERPRISE STREET STE 110 CITY: ESCONDIDO STATE: CA ZIP: 92029 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ONE STOP SYSTEMS, INC. CENTRAL INDEX KEY: 0001394056 STANDARD INDUSTRIAL CLASSIFICATION: ELECTRONIC COMPUTERS [3571] IRS NUMBER: 330885351 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2235 ENTERPRISE ST STE 110 CITY: ESCONDIDO STATE: CA ZIP: 92029 BUSINESS PHONE: 760-745-9883 MAIL ADDRESS: STREET 1: 2235 ENTERPRISE ST STE 110 CITY: ESCONDIDO STATE: CA ZIP: 92029 FORMER COMPANY: FORMER CONFORMED NAME: ONE STOP SYSTEMS INC DATE OF NAME CHANGE: 20070322 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-07-22 0 0001394056 ONE STOP SYSTEMS, INC. OSS 0001729604 Harrison Jack 2235 ENTERPRISE STREET #110 ESCONDIDO CA 92029 1 0 0 0 Common Stock 2021-07-22 4 M 0 19767 2.15 A 58884 D Common Stock Purchase Warrant 2.15 2021-07-22 4 M 0 19767 0.00 D 2019-04-04 2024-04-04 Common Stock 19767 0 I By LLC The reporting person beneficially owns the total number of shares reported in this column both directly, as well as indirectly through Jacoma Investments, LLC ("Jacoma") as the sole manager of Jacoma. The Common Stock Purchase Warrant was held directly be Jacoma, and indirectly by the reporting person as the sole manager of Jacoma. /s/ Jack Harrison 2021-07-26