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*
KIRK ALANA

(Last) (First) (Middle)
1881 GROVE AVENUE
ATTN: LEGAL DEPARTMENT

(Street)
RADFORD VA 24141

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
AquaBounty Technologies, Inc. [ AQB ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
12/17/2020
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 12/17/2020 J(1) 199,682(1) D $0(1) 0 I by NRM VI Holdings(1)
Common Stock 12/17/2020 J(2) 3,637(2) A $0(2) 0 I by NRM VII Holdings(2)
Common Stock 12/17/2020 J(1) 70,092(1) A $0(1) 316,495 I by R.J. Kirk DOT(3)
Common Stock 12/17/2020 J(2) 1,704(2) A $0(2) 318,199 I by R.J. Kirk DOT(3)
Common Stock 12/17/2020 J(1) 18,482(1) A $0(1) 37,064 I by JPK 2009(3)
Common Stock 12/17/2020 J(2) 303(2) A $0(2) 37,367 I by JPK 2009(3)
Common Stock 12/17/2020 J(1) 18,482(1) A $0(1) 40,237 I by MGK 2009(3)
Common Stock 12/17/2020 J(2) 303(2) A $0(2) 40,540 I by MGK 2009(3)
Common Stock 12/17/2020 J(1) 1,848(1) A $0(1) 3,801 I by ZSK 2009(3)
Common Stock 12/17/2020 J(2) 30(2) A $0(2) 3,831 I by ZSK 2009(3)
Common Stock 12/17/2020 J(2) 42(2) A $0(2) 3,189 I by JPK 2008(3)
Common Stock 12/17/2020 J(2) 42(2) A $0(2) 3,204 I by MGK 2008(3)
Common Stock 12/17/2020 J(1) 1,848(1) A $0(1) 4,541 I by ZSK 2008(3)
Common Stock 12/17/2020 J(2) 42(2) A $0(2) 4,583 I by ZSK 2008(3)
Common Stock 12/17/2020 J(2) 152(2) A $0(2) 17,758 I by MGK 2011(3)
Common Stock 12/17/2020 J(2) 121(2) A $0(2) 15,939 I by JPK 2012(3)
Common Stock 12/17/2020 J(1) 3,328(1) A $0(1) 5,842 I by Kellie L. Banks LTT(3)
Common Stock 12/17/2020 J(2) 24(2) A $0(2) 5,866 I by Kellie L. Banks LTT(3)
Common Stock 12/17/2020 J(2) 242(2) A $0(2) 23,831 I by Staff 2010(3)
Common Stock 12/17/2020 J(1) 20,712(1) A $0(1) 20,712 I by Staff 2009(3)
Common Stock 12/17/2020 J(1) 20,712(1) A $0(1) 44,301 I by Sr. Staff 2008(3)
Common Stock 12/17/2020 J(2) 242(2) A $0(2) 44,543 I by Sr. Staff 2008(3)
Common Stock 12/17/2020 J(1) 10,358(1) A $0(1) 10,358 I by Incentive 2009(3)
Common Stock 12/17/2020 J(2) 122(2) A $0(2) 11,917 I by Incentive 2010(3)
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
Explanation of Responses:
1. On December 17, 2020, NRM VI Holdings I, LLC ("NRM VI Holdings") made a liquidating distribution of its assets in connection with the dissolution of the fund in accordance with the terms of its Limited Liability Company Agreement, including 199,682 shares of the issuer. The following entities, each of which is controlled by the Reporting Person's spouse, in their capacities as limited partners, or designees, of one or more feeder funds of NRM VI Holdings, received shares: R.J. Kirk Declaration of Trust ("R.J. Kirk DOT"), JPK 2009, LLC ("JPK 2009"), MGK 2009, LLC ("MGK 2009"), ZSK 2009, LLC ("ZSK 2009"), ZSK 2008, LLC ("ZSK 2008"), Kellie L. Banks (2009) Long Term Trust ("Kellie L. Banks LTT"), Third Security Staff 2009 LLC ("Staff 2009"), Third Security Senior Staff 2008 LLC ("Sr. Staff 2008"), and Third Security Incentive 2009 LLC ("Incentive 2009").
2. On December 17, 2020, NRM VII Holdings I, LLC ("NRM VII Holdings") made a liquidating distribution of its assets in connection with the dissolution of the fund in accordance with the terms of its Limited Liability Company Agreement, including 3,637 shares of the issuer. The following entities, each of which is controlled by the Reporting Person's spouse, in their capacities as limited partners, or designees, of one or more feeder funds of NRM VI Holdings, received shares: R.J. Kirk DOT, JPK 2009, MGK 2009, ZSK 2009, JPK 2008, LLC ("JPK 2008"), MGK 2008, LLC ("MGK 2008"), ZSK 2008, MGK 2011, LLC ("MGK 2011"), JPK 2012, LLC ("JPK 2012"), Kellie L. Banks LTT, Sr. Staff 2008, Third Security Staff 2010 LLC ("Staff 2010") and Third Security Incentive 2010 LLC ("Incentive 2010").
3. The Reporting Person's spouse, Randal J. Kirk, controls each of ADC 2010, LLC ("ADC 2010"), Kapital Joe, LLC ("Kapital Joe"), Third Security Staff 2001 LLC ("Staff 2001"), Third Security Senior Staff LLC ("Sr. Staff"), Lotus Capital (2000) Company, Inc. ("Lotus"), Third Security, LLC ("Third Security"), Third Security Senior Staff 2006 LLC ("Sr. Staff 2006"), Third Security Staff 2006 LLC ("Staff 2006"), Third Security Incentive 2006 LLC ("Incentive 2006"), TS AquaCulture, LLC ("TS AquaCulture"), TS Biotechnology Holdings, LLC ("TS Bio"), Third Security Senior Staff 2007 LLC ("Sr. Staff 2007"), Third Security Staff 2007 LLC ("Staff 2007"), and Third Security Incentive 2007 LLC ("Incentive 2007"). Shares held by these entities may be deemed to be beneficially owned (as defined under Rule 13d-3 promulgated under the Securities Exchange Act of 1934, as amended) by Mr. Kirk. Mr. Kirk disclaims beneficial ownership of such shares, except to the extent of any pecuniary interest therein.
/s/ Alana D. Kirk 12/21/2020
** 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.