SEC Form 4 · accession 0001385150-16-000010
Acacia Diversified Holdings, Inc. · ACCA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Steven L Sample
Director · 10% Owner
Period of report
Aug 24, 2016
Accepted (ET)
Aug 30, 2016 · 4:20 pm EDT
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 stockF1,F2,F3 | Aug 30, 2016 | P | 1,200 | $1.7978 | A | 5,518,779 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Report covers transactions made from 8/24/2016 through 8/30/2016
- F2Report covers purchase of 1200 shares in open market at average price per share of $1.7978 during the period 08/24/2016 through 08/30/2016
- F3Following these transactions, the Reporting Person owned 5,518,779 shares of Common stock of Issuer. With the exception of 2,500,000 of those shares, Reporting Person disclaims any beneficial ownership in securities held by others, and disclaims beneficial ownership of any other person in his securities. The referenced 2,500,000 shares are currently held in trust by another person who holds a Proxy from Reporting Person to vote those shares and has a Right of First Refusal to Purchase those Common shares between April 4 and May 4, 2019, but who does not currently have beneficial ownership in those shares.
Remarks
Reporting Person disclaims any beneficial ownership in securities held by others, and disclaims beneficial ownership of any other person in his securities.