Sec Form 4/A Filing - Burns James Edward @ Petrolia Energy Corp - 2017-04-18

Every director, officer or owner of more than ten percent of a class of equity securities registered under Section 12 of the '34 Act must file with the U.S. Securities and Exchange Commission (SEC) a statement of ownership regarding such security.

Form 4: Statement of changes in beneficial ownership, filed before the end of the 2nd business day following the day on which a transaction resulting in a change in beneficial ownership.

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FORM 4/A
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person *
Burns James Edward
2. Issuer Name and Ticker or Trading Symbol
Petrolia Energy Corp [ BBLS]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
President
(Last)
(First)
(Middle)
3322 DESERT INN
3. Date of Earliest Transaction (MM/DD/YY)
04/18/2017
(Street)
MONTGOMERY, TX77356
4. If Amendment, Date Original Filed (MM/DD/YY)
06/15/2017
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City)
(State)
(Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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 1,550,000 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 (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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 of Derivative Security: 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
Series A Convertible Preferred Stock $ 0.14 05/26/2017 A 10,500 05/26/2017 ( 1 ) Common Stock 750,000 $ 10 10,500 D
Series A Convertible Preferred Stock $ 0.14 05/23/2017 A 3,000 05/23/2017 ( 1 ) Common Stock 214,286 $ 10 13,500 D
Series A Convertible Preferred Stock $ 0.14 04/18/2017 A 2,900 04/18/2017 ( 1 ) Common Stock 207,143 $ 10 16,400 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Burns James Edward
3322 DESERT INN
MONTGOMERY, TX77356
X President
Signatures
/s/ James E Burns 02/15/2018
** Signature of Reporting Person Date
Explanation of Responses:
( 1 )The Issuer's Series A Convertible Preferred Stock have a face value of $10 per share and convert into common stock of the Issuer (along with any accrued dividends thereon), at any time at the option of the holder thereof, and automatically when the Issuer's common stock market price equals or exceeds $0.30 per share for 30 consecutive days, at a conversion price of $0.14 per share (each share of preferred stock converts into 71.42 shares of common stock). The Series A Convertible Preferred Stock also accrues a cumulative dividend at a rate of 9% per annum and includes a blocker, preventing the conversion of such preferred stock into common stock if upon such conversion the holder would hold more than 4.99% of the Issuer's outstanding common stock.

Remarks:
This Form 4/A is being filed to correct certain errors in the disclosure of the preferred stock acquired by the Reporting Person as reported herein and move the preferred stock from the Non-Derivative Security table to the Derivative Security table due to the conversion terms thereof. This Form 4/A also corrects the earliest transaction date reported.

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).

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