0001493152-21-017584.txt : 20210722 0001493152-21-017584.hdr.sgml : 20210722 20210722203722 ACCESSION NUMBER: 0001493152-21-017584 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210720 FILED AS OF DATE: 20210722 DATE AS OF CHANGE: 20210722 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shalem Yaron CENTRAL INDEX KEY: 0001716133 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-09047 FILM NUMBER: 211108821 MAIL ADDRESS: STREET 1: 5 YISHAYAHU, STREET 2: AURECH STREET, CITY: TEL AVIV, STATE: L3 ZIP: 00000 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 2021-07-20 0 0000278165 OMNIQ Corp. OMQS 0001716133 Shalem Yaron C/O OMNIQ CORP. 1865 WEST 2100 SOUTH SALT LAKE CITY UT 84119 1 0 0 0 Common Stock 2021-07-20 2021-07-20 4 M 0 19025 2.20 A 19025 D Stock Option (right to buy) 2.20 2021-07-20 2021-07-20 4 M 0 25000 D 2021-08-02 Common stock 19025 0 D The stock options exercised herein reflect the cashless exercise of certain options scheduled to expire on August 2, 2021. In connection with the Company's 2014 Option Plan, 500,000 stock options were granted to Mr. Shalem 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 options in the stock option grant is 25,000. For this transaction, the number of options to be exercised by Mr. Shalem is 25,000. Following the net exercise, Mr. Shalem will have 0 remaining options from this class of options within the August 2, 2017 stock option grant. Upon exercise, the underlying net options convert into shares of the issuer's common stock on a one-for-one basis. /s/ Yaron Shalem 2021-07-22