Initial Statement of Beneficial Ownership (3)
24 January 2023 - 08:18AM
Edgar (US Regulatory)
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FORM 3
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UNITED STATES SECURITIES AND EXCHANGE
COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP
OF SECURITIES
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OMB
APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response... 0.5 |
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Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
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| 1. Name
and Address of Reporting Person * FG Next GP, LLC |
2. Date of Event Requiring Statement
(MM/DD/YYYY)
1/12/2023
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3. Issuer Name and Ticker or Trading
Symbol Molekule Group, Inc. [MKUL] |
|
(Last)
(First)
(Middle)
645 WALNUT ST., |
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director ___X___
10% Owner
_____ Officer (give title
below) _____
Other (specify below)
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(Street)
BOULDER, CO 80302
(City)
(State)
(Zip)
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5. If Amendment, Date Original
Filed(MM/DD/YYYY)
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6. Individual or Joint/Group
Filing(Check Applicable Line)
___ Form filed by One Reporting Person
_X_ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Beneficially
Owned
|
1.Title of Security
(Instr. 4) |
2. Amount of Securities Beneficially Owned
(Instr. 4) |
3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) |
4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
|
Common Stock |
7217710 |
I |
By Foundry Group Next ,L.P. (1) |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 4) |
2. Date Exercisable and Expiration Date
(MM/DD/YYYY) |
3. Title and Amount of Securities Underlying
Derivative Security
(Instr. 4) |
4. Conversion or Exercise Price of Derivative
Security |
5. Ownership Form of Derivative Security: Direct (D)
or Indirect (I)
(Instr. 5) |
6. Nature of Indirect Beneficial Ownership
(Instr. 5) |
|
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Explanation of
Responses: |
| (1) |
Shares are held by Foundry
Group Next, L.P. ("Foundry"). FG Next GP, L.L.C. ("Foundry GP") is
the general partner of Foundry and may be deemed to beneficially
own these shares. Lindel Eakman, Bradley A. Feld, Seth Levine,
Chris Moody and Ryan A. McIntyre are the managing members of
Foundry GP, and may be deemed to share voting and investment power
over these shares. Each of Foundry GP and Messrs. Eakman, Levine,
Moody and McIntyre disclaims beneficial ownership in these shares
except to the extent of its or his pecuniary interest therein. Mr.
Feld is a director of the Issuer and files separate Section 16
reports. |
Reporting
Owners
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|
Reporting Owner Name / Address |
Relationships
|
|
Director |
10% Owner |
Officer |
Other |
FG Next GP, LLC
645 WALNUT ST.
BOULDER, CO 80302 |
|
X |
|
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Foundry Group Next, L.P.
645 WALNUT ST.
BOULDER, CO 80302 |
|
X |
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Levine Seth
C/O FOUNDRY GROUP
645 WALNUT ST.
BOULDER, CO 80302 |
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X |
|
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MCINTYRE RYAN A
C/O FOUNDRY GROUP
645 WALNUT ST.
BOULDER, CO 80302 |
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X |
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Signatures
|
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FG Next GP, L.L.C., By /s/ Bradley A. Feld,
Managing Member |
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1/23/2023 |
| **Signature of Reporting
Person |
Date |
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Foundry Group Next, L.P., By: FG Next GP, L.L.C.,
its general partner, By /s/ Bradley A. Feld, Managing
Member |
|
1/23/2023 |
| **Signature of Reporting
Person |
Date |
|
/s/ Seth Levine |
|
1/23/2023 |
| **Signature of Reporting
Person |
Date |
|
/s/ Ryan A. McIntyre |
|
1/23/2023 |
| **Signature of Reporting
Person |
Date |
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Reminder: Report on a separate line for each class
of securities beneficially owned directly or
indirectly. |
| * |
If the form is filed by more than one
reporting person, see Instruction 5(b)(v). |
| ** |
Intentional misstatements or omissions
of facts constitute Federal Criminal Violations. See 18
U.S.C. 1001 and 15 U.S.C. 78ff(a). |
| Note: |
File three copies of this Form, one of
which must be manually signed. If space is insufficient, see
Instruction 6 for procedure. |
|
Persons who respond to the collection of information
contained in this form are not required to respond unless the form
displays a currently valid OMB control number. |
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