Insider filing report for Changes in Beneficial Ownership
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The following is an SEC EDGAR document rendered as filed.
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FORM 4
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 *
LEE DAVID DONGHIE
2. Issuer Name and Ticker or Trading Symbol
BioSolar Inc [ BSRC]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director X __ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
CEO, Acting CFO
(Last)
(First)
(Middle)
BIOSOLAR INC, 27936 LOST CANYON ROAD SUITE 202
3. Date of Earliest Transaction (MM/DD/YY)
12/19/2016
(Street)
SANTA CLARITA, CA91387
4. If Amendment, Date Original Filed (MM/DD/YY)
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 12/19/2016 J( 1 ) 1,316,235 A 4,769,290 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
Convertible Note ( 1 ) 12/19/2016 J( 1 ) 1,316,235 12/18/2014 12/18/2016 Common Stock 1,316,235 ( 1 ) 0 ( 1 ) D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
LEE DAVID DONGHIE
BIOSOLAR INC
27936 LOST CANYON ROAD SUITE 202
SANTA CLARITA, CA91387
X X CEO, Acting CFO
Signatures
/s/ David Lee 12/21/2016
** Signature of Reporting Person Date
Explanation of Responses:
( 1 )Common Stock was issued to Reporting Person upon the conversion of a convertible promissory note (the "Promissory Note") granted to the Reporting Person by the Issuer pursuant to a Convertible Note Agreement dated December 18, 2014, which was issued directly to Reporting Person by the Issuer in satisfaction of unpaid salary. The balance of the Promissory Note was convertible into shares of the Issuer's common stock at a conversion price equal to the lesser of (i) $0.101 per share, or (ii) the closing prices of the Issuer's common stock on the last complete trading day immediately preceding the date of conversion. The original balance of the Promissory Note was $67,000. There is no longer a balance on this Promissory Note.

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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