SEC Form 4/A · accession 0001144204-15-002893
CV Sciences, Inc. · CVSI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Michael Mona III
Officer — Vice President of Operations
Period of report
Oct 1, 2014
Accepted (ET)
Jan 20, 2015 · 9:42 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001510964
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Oct 1, 2014 | A | 250,000 | $0.00 | A | 2,500,000 | D | |
| Common StockF2,F3 | Jan 2, 2015 | A | 250,000 | $0.00 | A | 1,750,000 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The shares were issued pursuant to that certain Stock Award Agreement, dated as of October 1, 2014, by and between Mr. Mona and the Issuer under the Issuer's Amended and Restated 2013 Equity Incentive Plan ("Stock Award Agreement"). The consideration for the grant of the shares was services previously rendered to the Issuer by Mr. Mona, valued at $705,000, as of October 1, 2014.
- F2The shares were issued pursuant to the Stock Award Agreement. The consideration for the grant of the shares was services previously rendered to the Issuer by Mr. Mona, valued at $590,000, as of January 2, 2015.
- F3Excludes 1,000,000 shares previously owned indirectly by Mr. Mona as co-trustee of the Roche-Denis Trust ("Trust"). As of November 19, 2014, Mr. Mona was no longer the co-trustee or beneficiary of the Trust.