Statement of Changes in Beneficial Ownership (4)
10 March 2021 - 9:39AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
1. Name and Address of Reporting Person
*
CRW Capital, LLC |
2. Issuer Name and Ticker or Trading Symbol
Medicine Man Technologies, Inc.
[
SHWZ
]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below)
|
(Last)
(First)
(Middle)
4740 W. MOCKINGBIRD LANE, P.O. BOX 195579 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/3/2021 |
(Street)
DALLAS, TX 75209
(City)
(State)
(Zip)
|
4. 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
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
|
1.Title of Security (Instr. 3)
|
2. Trans. Date
|
2A. Deemed Execution Date, if any
|
3. Trans. Code (Instr. 8)
|
4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
|
5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
|
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
|
7. Nature of Indirect Beneficial Ownership (Instr. 4)
|
Code
|
V
|
Amount
|
(A) or (D)
|
Price
|
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Series A Cumulative Convertible Preferred Stock | $1.20 (1) | 3/3/2021 | | P | | 2100 | | (2) | (2) | Common Stock | 1750000 (3) | $1000 | 25350 | I | See Footnote (4) |
Explanation of Responses: |
(1) | Subject to adjustment, as described in the Certificate of Designation of Series A Cumulative Convertible Preferred Stock (the "Certificate of Designation") of Medicine Man Technologies, Inc. (the "Company"). |
(2) | The shares of Series A Cumulative Convertible Preferred Stock (the "Series A Preferred Shares") are convertible into shares of the Company's common stock (the "Common Shares") upon the events specified in the Certificate of Designation. The Series A Preferred Shares have no expiration date. |
(3) | Represents the number of Common Shares issuable upon conversion of the Series A Preferred Shares on the date of the reported transaction. Each Series A Preferred Share shall be convertible into that number of Common Shares equal to the preference amount (initially $1,000) plus any accrued dividends with respect to such share, divided by the conversion price (initially $1.20), subject to adjustment as set forth in the Certificate of Designation. The Series A Preferred Shares earn a cumulative dividend of 8% per annum. |
(4) | CRW Capital Cann Holdings, LLC (the "Holder") is the record holder of the reported shares. Marc R. Rubin is a manager of CRW Capital, LLC, which is the sole manager of the Holder. Each of Mr. Rubin and CRW Capital, LLC disclaims beneficial ownership of the reported shares except to the extent of his or its pecuniary interest therein. |
Reporting Owners
|
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
CRW Capital, LLC 4740 W. MOCKINGBIRD LANE P.O. BOX 195579 DALLAS, TX 75209 |
| X |
|
|
CRW Capital Cann Holdings, LLC 4740 W. MOCKINGBIRD LANE P.O. BOX 195579 DALLAS, TX 75209 |
| X |
|
|
Rubin Marc R 4740 W. MOCKINGBIRD LANE P.O. BOX 195579 DALLAS, TX 75209 |
| X |
|
|
Signatures
|
/s/ Marc R. Rubin, individually, and as Treasurer of each of CRW Capital Cann Holdings, LLC & CRW Capital, LLC | | 3/9/2021 |
**Signature of Reporting Person | Date |
Medicine Man Technologies (QX) (USOTC:SHWZ)
Historical Stock Chart
From Apr 2024 to May 2024
Medicine Man Technologies (QX) (USOTC:SHWZ)
Historical Stock Chart
From May 2023 to May 2024