SEC Form 3
FORM 3 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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1. Name and Address of Reporting Person*
Ballengee James H.

(Last) (First) (Middle)
5151 BELTLINE ROAD, SUITE 715

(Street)
DALLAS TX 75234

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/01/2022
3. Issuer Name and Ticker or Trading Symbol
Vivakor, Inc. [ VIVK ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common stock, par value $0.001 3,009,552 I See Footnote(1)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Promissory Note (2) 08/01/2025 Common stock(2) (2) (2) I See Footnote(2)
Explanation of Responses:
1. Mr. Ballengee has beneficial ownership of shares owned by Jorgan Development, LLC (2,979,456 shares) and JBAH Holdings, LLC (30,096 shares).
2. August 1,2022, Vivakor, Inc. ("Vivakor") issued 3-year secured, convertible promissory notes ("Notes") in the aggregate principal amount of $28,664,284 to Jorgan Development, LLC ($28,337,641) and JBAH Holdings, LLC ($286,643). Payment of principal and interest is payable monthly on the twentieth day of the month with the first payment payable on September 20, 2022. Subject to compliance with Nasdaq Rule 5635(d), on each payment date, Vivakor can make payment of principal and interest in the form of unrestricted shares of Vivakor common stock valued at the five-day volume weighted average price for Vivakor's common stock during the 5 trading days immediately preceding the issuance date ("Stock"). No more than 50% of any monthly payment of principal and interest and no more than 50% of the original principal amount of the Notes can be paid in Stock without the consent of the applicable noteholder.
/s/ James Ballengee 08/11/2022
** Signature of Reporting Person Date
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 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).
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