Ownership Submission
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FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549INITIAL 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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OMB APPROVAL
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OMB Number:3235-0104Expires:January 31, 2005Estimated average burden hours per response...0.5
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1. Name and Address of Reporting Person *
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Crawford Gregory John
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2. Date of Event Requiring Statement (Month/Day/Year)
2024-10-01
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3. Issuer Name and Ticker or Trading Symbol
Quipt Home Medical Corp. [QIPT]
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(Last)
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(First)
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(Middle)
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C/O QUIPT HOME MEDICAL CORP. , 1019 TOWN DRIVE
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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__X__ Director
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_____ 10% Owner
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_____ Officer (give title below)
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_____ Other (specify below)
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President/CEO /
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5. If Amendment, Date Original Filed(Month/Day/Year)
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6. Individual or Join/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
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2. Amount of Securities Beneficially Owned
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3. Ownership Form: Direct (D) or Indirect (I)
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4. Nature of Indirect Beneficial Ownership
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
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2. Date Exercisable and Expiration Date
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3. Title and Amount of Securities Underlying Derivative Security
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
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6. Nature of Indirect Beneficial Ownership
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Date Exercisable
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Expriation Date
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Title
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Amount or Number of Shares
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Crawford Gregory John
C/O QUIPT HOME MEDICAL CORP.
1019 TOWN DRIVE
WILDER, KY41076
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X
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President/CEO
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Signatures
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/s/ Gregory John Crawford
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2024-10-01
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**Signature of Reporting Person
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Date
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Explanation of Responses:
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(*)
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If the form is filed by more than one reporting person, see Instruction 5(b)(v).
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(**)
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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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(1)
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Shares are held by the Gregoy J. Crawford Family 2017 Children's Trust for the benefit of Mr. Crawford's children. Mr. Crawford disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that Mr. Crawford is the beneficial owner of the securities for purposes of Section 16 or for any other purpose.
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(2)
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The exercise price for this award is denominated in Canadian dollars at 1.50. All these options have vested according to the award agreement and are, as of October 1, 2024, exercisable. Converted from Canadian dollars to United States dollars as of the date hereof at a conversion rate of 0.74 United States dollars per Canadian dollar.
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(3)
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The exercise price for this award is denominated in Canadian dollars at 8.48. All these options have vested according to the award agreement and are, as of October 1, 2024, exercisable. Converted from Canadian dollars to United States dollars as of the date hereof at a conversion rate of 0.74 United States dollars per Canadian dollar.
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(4)
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Each restricted share unit ("RSU") is the economic equivalent of one Common Share. Vested RSUs shall be settled in Common Shares. The RSUs shall vest in equal amounts as follows: February 20, 2024, May 20, 2024, August 20, 2024, November 20, 2024, and February 20, 2025.
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Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
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