QHSLab Inc.

02/13/2026 | Press release | Distributed by Public on 02/13/2026 15:31

Annual Statement of Changes in Beneficial Ownership (Form 5)

FORM 5
Check this box if no longer subject to Section 16, Form 4 or Form 5 obligations may continue. See Instruction 1(b).
Form 3 Holdings Reported
Form 4 Transactions Reported
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN 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 *
Grogan Troy James
2. Issuer Name and Ticker or Trading Symbol
QHSLab, Inc. [USAQ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
President and CEO /
(Last) (First) (Middle)
901 NORTHPOINT PARKWAY , SUITE 302
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
2025-12-31
(Street)
WEST PALM BEACH FL 33407
4. If Amendment, Date Original Filed (Month/Day/Year)
6. Individual or Join/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 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code 4. Securities Acquired (A) or Disposed of (D) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) 6. Ownership Form: Direct (D) or Indirect (I) 7. Nature of Indirect Beneficial Ownership
Amount (A) or (D) Price
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code 5. Number of Derivative Securities Acquired (A) or Disposed of (D) 6. Date Exercisable and Expiration Date 7. Title and Amount of Securities Underlying Derivative Security 8. Price of Derivative Security 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) 11. Nature of Indirect Beneficial Ownership
(A) (D) Date Exercisable Expriation Date Title Amount or Number of Shares

Reporting Owners

Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Grogan Troy James
901 NORTHPOINT PARKWAY
SUITE 302
WEST PALM BEACH, FL33407
X X President and CEO

Signatures

/s/ Troy Grogan 2026-02-13
**Signature of Reporting Person Date

Explanation of Responses:

(*) 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).
(1) Represents shares issued in satisfaction of dividends accrued as of December 31, 2024, on Series A-2 Convertible Preferred Stock.
(2) Represents 2,644,424 shares of Series A-2 Preferred Stock issued to the Reporting Person on December 30, 2021, in satisfaction of convertible promissory notes in the aggregate principal amount of $286,078 together with all interest accrued thereon. The Series A-2 Convertible Preferred Stock bears a cumulative dividend which accrues at the rate of 7% per annum. Each share of Series A Convertible Preferred stock has a stated value of $0.16 and is convertible into common stock at a price of $0.16 per share.
(3) Represents 1,080,92 shares of Series A Preferred Stock issued to the Reporting Person on September 1, 2019, in satisfaction of convertible promissory notes in the aggregate principal amount of $255,681 together with all interest accrued thereon. The Series A Convertible Preferred Stock does not bear a dividend. Each share of Series A Convertible Preferred stock has a stated value of $0.25 and is convertible into common stock at a price of $0.05 per share.
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
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