0001493152-19-016625.txt : 20191107
0001493152-19-016625.hdr.sgml : 20191107
20191107161533
ACCESSION NUMBER: 0001493152-19-016625
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191105
FILED AS OF DATE: 20191107
DATE AS OF CHANGE: 20191107
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: 191200517
MAIL ADDRESS:
STREET 1: TRAVESA DE PRAIA 128
CITY: PRAIA DA LUZ
STATE: S1
ZIP: 8600
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Quest Solution, Inc.
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: AMERIGO ENERGY, INC.
DATE OF NAME CHANGE: 20081112
FORMER COMPANY:
FORMER CONFORMED NAME: STRATEGIC GAMING INVESTMENTS, INC.
DATE OF NAME CHANGE: 20060501
FORMER COMPANY:
FORMER CONFORMED NAME: LEFT RIGHT MARKETING TECHNOLOGY INC
DATE OF NAME CHANGE: 20031002
4
1
ownership.xml
X0306
4
2019-11-05
0
0000278165
Quest Solution, Inc.
QUES
0001745012
Nissensohn Carlos Jaime
C/O QUEST SOLUTION, INC.
1865 WEST 2100 SOUTH
SALT LAKE CITY
UT
84119
0
0
1
0
Common Stock
2019-11-05
4
A
0
317796
0
A
14586111
I
See Footnote
On October 5, 2018, Quest Solution, Inc. (the "Company") entered into a purchase agreement (the "Purchase Agreement") with Campbeltown Consulting, Ltd. ("Campbeltown"), Pursuant to the Purchase Agreement, the Company issued to Campbeltown a convertible promissory note with a principal amount of $700,000 and an interest rate of six percent (6%) per annum (the "Note"). Pursuant to the Note, Campbeltown may convert any and all accrued and unpaid principal and interest into shares of the Company's common stock at an exercise price of $0.236 per share (the "Exercise Price"). As of November 4, 2019, the accrued and unpaid balance under the Note was $150,000 (the "Balance"). On November 5, 2019, the Company and Campbeltown entered into a conversion agreement, pursuant to which Campbeltown agreed to convert $75,000 of the Balance at the Exercise Price and into 317,796 shares of the Company's common stock.
The shares are held by Campbeltown Consulting Ltd., which is beneficially owned by Mr. Nissensohn.
/s/ Carlos Jaime Nissensohn
2019-11-07