Form 4 Chang Robby Sai Kit

4 - Statement of changes in beneficial ownership of securities

Published: 2018-09-24 20:40:40
Submitted: 2018-09-24
Period Ending In: 2018-09-20
doc1.html FORM 4


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SEC FORM 4

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
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
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*
Chang Robby Sai Kit

(Last) (First) (Middle)
C/O RIOT BLOCKCHAIN, INC.
202 6TH STREET, SUITE 401

(Street)
CASTLE ROCK CO 80104

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Riot Blockchain, Inc. [ RIOT ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
3. Date of Earliest Transaction (Month/Day/Year)
09/20/2018
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 09/20/2018 M(1) 12,000(2) A $0.00(2) 72,000(3) 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
Restricted Stock Unit (2) 09/20/2018 M 12,000 (2) (4) Common Stock 12,000 $0.00 12,000(5) D
Explanation of Responses:
1. Represents the 12,000 vested Restricted Stock Units ("RSUs") reported in Column 5 of Table I on page one above, convertible into shares of the Issuer's Common Stock on a one-for-one basis pursuant to the Riot Blockchain, Inc. (f/k/a Bioptix, Inc.) Amended & Restated Equity Incentive Plan (the "Plan").
2. Represents a restricted stock award granted to the Reporting Person by the Issuer under the Plan at no cost as employment incentive on September 20, 2018, which award vested on the date of grant, subject to the restrictions of the Plan.
3. Includes an award of 60,000 RSUs granted on February 27, 2018 in connection with the Reporting Person's appointment as Chief Financial Officer, which shall vest in 24 equal monthly installments over a two year period, beginning on the one month anniversary of the date of issuance.
4. Not applicable.
5. Represents only the 12,000 RSUs granted on September 20, 2018 and does not include RSUs previously reported.
/s/ Robby Sai Kit Change 09/24/2018
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.
1
doc1.xml FORM 4
Schema Version:
X0306
Document Type:
4
Period Of Report:
2018-09-20
Not Subject To Section16:
0

Issuer

Issuer Cik
0001167419
Issuer Name
Riot Blockchain, Inc.
Issuer Trading Symbol
RIOT

Reporting Owner

Reporting Owner Id

Rpt Owner Cik
0001732700
Rpt Owner Name
Chang Robby Sai Kit

Reporting Owner Address

Rpt Owner Street1
C/O RIOT BLOCKCHAIN, INC.
Rpt Owner Street2
202 6TH STREET, SUITE 401
Rpt Owner City
CASTLE ROCK
Rpt Owner State
CO
Rpt Owner Zip Code
80104

Reporting Owner Relationship

Is Director
0
Is Officer
1
Is Ten Percent Owner
0
Is Other
0
Officer Title
Chief Financial Officer

Non Derivative Transaction

Security Title
Common Stock
Transaction Date
2018-09-20

Transaction Coding

Transaction Form Type
4
Transaction Code
M
Equity Swap Involved
0
@attributes Id
F1

Transaction Amounts

Transaction Shares

Value
12000
@attributes Id
F2

Transaction Price Per Share

Value
0.00
@attributes Id
F2
Transaction Acquired Disposed Code
A

Shares Owned Following Transaction

Value
72000
@attributes Id
F3
Direct Or Indirect Ownership
D

Derivative Transaction

Security Title
Restricted Stock Unit
@attributes Id
F2
Transaction Date
2018-09-20

Transaction Coding

Transaction Form Type
4
Transaction Code
M
Equity Swap Involved
0

Transaction Amounts

Transaction Shares
12000
Transaction Price Per Share
0.00
Transaction Acquired Disposed Code
A
@attributes Id
F2
@attributes Id
F4

Underlying Security

Underlying Security Title
Common Stock
Underlying Security Shares
12000

Shares Owned Following Transaction

Value
12000
@attributes Id
F5
Direct Or Indirect Ownership
D

Footnote

0
Represents the 12,000 vested Restricted Stock Units ("RSUs") reported in Column 5 of Table I on page one above, convertible into shares of the Issuer's Common Stock on a one-for-one basis pursuant to the Riot Blockchain, Inc. (f/k/a Bioptix, Inc.) Amended & Restated Equity Incentive Plan (the "Plan").
1
Represents a restricted stock award granted to the Reporting Person by the Issuer under the Plan at no cost as employment incentive on September 20, 2018, which award vested on the date of grant, subject to the restrictions of the Plan.
2
Includes an award of 60,000 RSUs granted on February 27, 2018 in connection with the Reporting Person's appointment as Chief Financial Officer, which shall vest in 24 equal monthly installments over a two year period, beginning on the one month anniversary of the date of issuance.
3
Not applicable.
4
Represents only the 12,000 RSUs granted on September 20, 2018 and does not include RSUs previously reported.

Owner Signature

Signature Name
/s/ Robby Sai Kit Change
Signature Date
2018-09-24
Additional Files
FileSequenceDescriptionTypeSize
0001567619-18-003075.txt   Complete submission text file   8137
$RIOT

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