11/06/2025 | Press release | Distributed by Public on 11/06/2025 17:30
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FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
| 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 control number. | |||
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1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security |
5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Series B Convertible Perpetual Preferred Stock | 06/20/2025 | (1) | Common Stock | (2) | $14.02 | D | |
| Reporting Owner Name / Address | Relationships | |||
| Director | 10% Owner | Officer | Other | |
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Jirapongphan Siri C/O PURECYCLE TECHNOLOGIES, INC. 20 NORTH ORANGE AVENUE STE 106 ORLANDO, FL 32801 |
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| /s/ Brad S. Kalter as attorney-in-fact for Siri Jirapongphan | 11/06/2025 | |
| **Signature of Reporting Person | Date |
| * | If the form is filed by more than one reporting person, see Instruction 5(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). |
| (1) | The Series B Convertible Perpetual Preferred Stock is perpetual and therefore has no expiration date. |
| (2) | Dr. Jirapongphan purchased 300 shares of the Series B securities at an initial issue price of $1,000 per share, for an aggregate purchase price of $300,000. The Series B Convertible Perpetual Preferred Stock is convertible into shares of Common Stock of the issuer at a conversion rate equal to (a) the sum of $1,000 plus in kind dividends plus accrued dividends divided by (b) the conversion price. |
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Remarks: Exhibit 24 - Power of Attorney |
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