Initial Statement of Beneficial Ownership (3)
August 18 2022 - 12:29PM
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
*
Wang Bernard |
2. Date of Event Requiring Statement (MM/DD/YYYY)
8/8/2022
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3. Issuer Name and Ticker or Trading Symbol
Greenrose Holding Co Inc. [GNRS]
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(Last)
(First)
(Middle)
5575 TERRACE DR. |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) CHIEF FINANCIAL OFFICER / |
(Street)
LA CRESCENTA, CA 91214
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ 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) |
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 |
Stock Options | (1) | 8/8/2037 | Common Stock | 43963 | $2.3800 | D | |
Stock Options | (2) | 8/8/2037 | Common Stock | 131887 | $2.3800 | D | |
Explanation of Responses: |
(1) | Consists of fully vested options to purchase shares of Common Stock granted under The Greenrose Holding Company Inc. 2021 Equity Incentive Plan (the "Equity Plan"). |
(2) | Consists of options to purchase shares of Common Stock granted under the Equity Plan, subject to vesting in twenty-four (24) months in equal installments commencing on February 8, 2023. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Wang Bernard 5575 TERRACE DR. LA CRESCENTA, CA 91214 |
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| CHIEF FINANCIAL OFFICER |
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Signatures
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/s/ BERNARD WANG | | 8/18/2022 |
**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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