Initial Statement of Beneficial Ownership (3)
24 January 2023 - 8:18AM
Edgar (US Regulatory)
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
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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
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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]
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(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)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
___ Form filed by One Reporting Person
_X_ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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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)
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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 |
| X |
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MCINTYRE RYAN A C/O FOUNDRY GROUP 645 WALNUT ST. BOULDER, CO 80302 |
| X |
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Signatures
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FG Next GP, L.L.C., By /s/ Bradley A. Feld, Managing Member | | 1/23/2023 |
**Signature of Reporting Person | Date |
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 |
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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