UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
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) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Employee stock option (right to buy) | (1) | 06/25/2030 | Common stock, no par value | 400,000 (1) | $ 0.5 (2) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Hoch Brad C/O TILT HOLDINGS INC. 2801 E. CAMELBACK ROAD #180 PHOENIX, AZ 85016 |
Chief Financial Officer |
/s/ Mark M. Higgins as attorney-in-fact for Brad Hoch | 06/21/2022 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Each stock option is exercisable for one share of Common Stock. The options vested as to 200,000 shares of Common Stock on June 26, 2021, with 1/12 of the remaining 200,000 options vesting monthly thereafter, subject to the Reporting Person's continued employment with the Issuer on each vesting date. |
(2) | The exercise price of the options is $0.65 Canadian dollars per share of common stock. The amount in column 4 is converted to U.S. dollars using the exchange rate as of June 17, 2022 as reported by the Bank of Canada. |
Remarks: Exhibit List: Exhibit 24.1 - Power of Attorney |