SEC Form 4 · accession 0001380389-17-000003
Acacia Diversified Holdings, Inc. · ACCA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Richard K Pertile
Officer — Chief Executive Officer · Director · 10% Owner
Period of report
Jan 24, 2017
Accepted (ET)
Jan 26, 2017 · 5:15 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001001463
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF2 | Jan 24, 2017 | P | 2,500,000 | $0.001 | A | 4,734,000 | D | |
| Common StockF4 | Jan 24, 2017 | J | 100,000 | $0.00 | A | 4,834,000 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Reporting Person acquired 2,500,000 shares of the Issuer's common stock in a private transaction with another affiliate of the Issuer.
- F2The price per share was determined by the Reporting Person and the affiliated person as part of their private transaction.
- F3The shares were issued in connection with a loan made by the Reporting Person to the Issuer for operating capital.
- F4Price was fixed by the board of directors as an incentive for Reporting Person to loan funds to the Issuer for operating capital.