0001515156-23-000013 4 1 20230201 20230203 20230203 Blank Jeremy 0001962987 4 34 001-37822 23587894 6446 DREXEL AVENUE LOS ANGELES CA 90048 Advanced Emissions Solutions, Inc. 0001515156 2890 275472457 1231 8051 E. MAPLEWOOD AVE., STE 210 GREENWOOD VILLAGE CO 80111 720-598-3500 8051 E. MAPLEWOOD AVE., STE 210 GREENWOOD VILLAGE CO 80111 4 1 wf-form4_167546819253817.xml FORM 4 FORM 4 OMB APPROVAL ? Check this box OMB Number: if no longer UNITED STATES SECURITIES AND EXCHANGE COMMISSION 3235-0287 subject to Washington, D.C. 20549 Estimated Section 16. Form STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF average burden 4 or Form 5 SECURITIES hours per obligations may response... 0.5 continue. See Instruction 1(b). Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 1. Name and Address of Reporting 2. Issuer Name and Ticker 5. Relationship of Person * or Trading Symbol Reporting Person(s) to Blank Jeremy Advanced Emissions Issuer (Check all Solutions, Inc. [ ADES ] applicable) __X__ Director _____ 10% Owner (Last) (First) (Middle) 3. Date of Earliest _____ Officer (give title C/O ADVANCED EMISSIONS SOLUTIONS, Transaction (MM/DD/YYYY) below) _____ Other INC., 8051 E. MAPLEWOOD AVENUE, 2/1/2023 (specify below) SUITE 210 (Street) 4. If Amendment, Date 6. Individual or GREENWOOD VILLAGE, CO 80111 Original Filed Joint/Group Filing (Check (MM/DD/YYYY) 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. Trans. Date 2A. 3. Trans. 4. Securities Acquired 5. Amount of 6. Ownership 7. Nature of (Instr. 3) Deemed Code (A) or Disposed of (D) Securities Form: Direct (D) Indirect Execution (Instr. 8) (Instr. 3, 4 and 5) Beneficially or Indirect (I) Beneficial Date, if Owned Following (Instr. 4) Ownership (Instr. any Reported 4) Transaction(s) (A) (Instr. 3 and 4) or Code V Amount (D) Price Common Stock 2/1/2023 P 631,866 A $4 631,866 I See footnote. (1) Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) 1. Title of 2. 3. Trans. Date 3A. 4. Trans. Code 5. Number of 6. Date Exercisable 7. Title and Amount of 8. Price 9. Number of 10. 11. Nature of Derivate Security Conversion Deemed (Instr. 8) Derivative and Expiration Date Securities Underlying of derivative Ownership Indirect (Instr. 3) or Execution Securities Acquired Derivative Security Derivative Securities Form of Beneficial Exercise Date, if (A) or Disposed of (Instr. 3 and 4) Security Beneficially Derivative Ownership (Instr. Price of any (D) (Instr. 5) Owned Security: 4) Derivative (Instr. 3, 4 and 5) Following Direct (D) Security Reported or Transaction(s) Indirect Date Expiration Amount or (Instr. 4) (I) Exercisable Date Title Number of (Instr. 4) Code V (A) (D) Shares Warrants (right $0.01 2/1/2023 J (2) 1 2/1/2023 2/1/2030 Common 325,457 (2) 1 I See to buy) Stock footnote. (2) Explanation of Responses: (1) The shares reported on this row are held by YGF 100 LP. Jeremy Blank, a Director of the Issuer, is the general partner of YGF 100 LP. Mr. Blank is an investor in YGF 100 LP and therefore is an indirect beneficial owner of a portion of these shares. Mr. Blank disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. (2) The warrant reported on this row (the "Warrant") was issued by the Issuer to CF Global Credit, LP in connection with that certain Term Loan and Security Agreement, dated as of February 1, 2023 (the "Loan Agreement") and as consideration for the term loan pursuant to the Loan Agreement. The Warrant has an exercise price of $0.01 per share, subject to adjustment as set forth in the Warrant, is exercisable immediately and will expire on February 1, 2030. The terms of the Warrant do not allow for cash exercise and the Warrant may only be exercised pursuant to the terms thereof. Mr. Blank controls the general partner of CF Global Credit, LP. Mr. Blank is an investor in CF Global Credit, LP and therefore is an indirect beneficial owner of a portion of the shares underlying the Warrant. Mr. Blank disclaims beneficial ownership of the shares underlying the Warrant except to the extent of his pecuniary interest therein. Reporting Owners Reporting Owner Name / Address Relationships Director 10% Owner Officer Other Blank Jeremy C/O ADVANCED EMISSIONS SOLUTIONS, INC. X 8051 E. MAPLEWOOD AVENUE, SUITE 210 GREENWOOD VILLAGE, CO 80111 Signatures /s/ Jeremy Blank 2/3/2023 ** 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 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). 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 control number.