SEC Form 4 · accession 0001385150-16-000011
Acacia Diversified Holdings, Inc. · ACCA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common stockF1,F2,F3 | Nov 11, 2016 | G | 1,491,058 | $0.00 | D | 4,029,721 | D |
Table II — derivative securities
Explanation of responses
- F1Transactions included 491,058 shares gifted on 10/31/2016 and 1,000,000 shares gifted on 11/11/2016 for a total of 1,491,058 shares.
- F2Shares gifted to others by the Reporting Person
- F3Following these gifting transactions, Reporting Person owned 4,029,721 shares of the Common stock of Issuer. 2,500,000 of those shares are currently held in trust by another person who holds a Proxy from Reporting Person to vote those shares and the Right of First Refusal to purchase those Common shares between April 4th and May 4th of 2019, but who does not currently have beneficial ownership of those shares.
Remarks
Reporting Person is reporting an ownership interest of 10% or more of the issued and outstanding Common shares of Issuer. However; Following these gifting transactions, Reporting Person owned 4,029,721 shares of the Common stock of Issuer. 2,500,000 of those shares are currently held in trust by another person who holds a Proxy from Reporting Person to vote those shares and the Right of First Refusal to purchase those Common shares between April 4th and May 4th of 2019, but who does not currently have beneficial ownership of those shares. As such, Reporting Person does not hold the influence of 10% or more of the Issuer's outstanding shares.