Sec Form 4 Filing - Nissensohn Carlos Jaime @ Quest Solution, Inc. - 2018-10-05

Insider filing report for Changes in Beneficial Ownership
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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
Nissensohn Carlos Jaime
2. Issuer Name and Ticker or Trading Symbol
Quest Solution, Inc. [ QUES]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
TRAVESSA DA PRAIA 12B
3. Date of Earliest Transaction (MM/DD/YY)
10/05/2018
(Street)
PRAIA DA LUZ, S18600
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 10/05/2018 J( 1 ) 11,226,477 A $ 0.236 19,593,977 I See footnote ( 2 )
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 Promissory Note $ 0.236 10/05/2018 J( 3 ) 1,483,051 10/11/2018 10/11/2019 Common stock 1,483,051 $ 350,000 1,483,051 I See footnote ( 3 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Nissensohn Carlos Jaime
TRAVESSA DA PRAIA 12B
PRAIA DA LUZ, S18600
X
Signatures
/s/ Carlos Jaime Nissensohn 10/11/2018
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The shares were acquired by Mr. Nissensohn's company, Campbeltown Consulting Ltd., in the Purchase Agreement dated October 05, 2018 by and among Quest Solution, Inc., Campbeltown Consulting, Ltd. and Walefar Investments, Ltd.
( 2 )The shares are held by Campbeltown Consulting Ltd. which is beneficially owned by Mr. Nissensohn.
( 3 )The convertible promissory note was issued to Mr. Nissensohn's company, Campbeltown Consulting Ltd., in the Purchase Agreement dated October 05, 2018 by and among Quest Solution, Inc., Campbeltown Consulting, Ltd. and Walefar Investments, Ltd.

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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