SEC Form 4 · accession 0001128732-17-000021
Medicine Man Technologies, Inc. · MDCL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Andrew Johns Williams
Director · 10% Owner
Period of report
Jun 7, 2017
Accepted (ET)
Jul 17, 2017 · 9:05 am EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001622879
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Jun 7, 2017 | A | 375,000 | $0.93 | A | 375,000 | I | Held in the name of Andrew Johns Williams Revocable Trust Dated May 28, 2015 |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock WarrantsF2 | $1.445 | Jun 7, 2017 | A | 750,000 | A | Jun 7, 2017 | Dec 31, 2019 | Common Stock | 750,000 | 750,000 | I |
Explanation of responses
- F1Reporting Person received shares of restricted Common Stock issued pursuant to the terms of the Issuer's 2017 Equity Incentive Plan.
- F2Reporting Person is the Trustee of the Andrew Johns Williams Revocable Trust Dated May 28, 2015 and, as such, has dispositive power over the shares.