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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*
Tiramani Galiano Paolo

(Last) (First) (Middle)
5345 E. N. BELT ROAD

(Street)
NORTH LAS VEGAS NV 89115

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/09/2023
3. Issuer Name and Ticker or Trading Symbol
Boxabl Inc. [ BOX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Director of Marketing
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 $0.00001 375,955,800 D
Common Stock, par Value $0.00001 397,800,000 I By the Galiano Tiramani 2020 Family Gift Trust(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
Series A Preferred Stock (2) (2) Common Stock, par value $0.00001 $4,869,776 (2) I By Spouse
Non-Qualified Stock Options 10/04/2021 10/04/2031 Common Stock, par value $0.00001 $5,633,800 $0.071 I By Spouse
Explanation of Responses:
1. The Galiano Tiramani 2020 Family Gift Trust is held for the benefit of Mr. Tiramani's family. Mr. Tiramani is not the trustee of the trust nor is the trust held for his benefit. Paolo Tiramani, who is Galiano Tiramani's father and serves and CEO and Director of Boxabl Inc., serves as trustee.
2. Each share of Series A Preferred Stock automatically converts into shares of the Company's Common Stock on a one-for-one basis upon the closing of the sale of the Company's Common Stock to the public in a firm-commitment underwritten public offering that meets certain criteria or an offering of the Company's Common Stock in reliance on Regulation A of the Securities Act of 1933, as amended.
/s/ Sandy Godsey, Attorney-in-fact 10/10/2023
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.