Initial Statement of Beneficial Ownership (3)
July 13 2017 - 4:26PM
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
*
Lacey Kevin Patrick
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2. Date of Event Requiring Statement (MM/DD/YYYY)
7/5/2017
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3. Issuer Name
and
Ticker or Trading Symbol
TAURIGA SCIENCES, INC. [TAUG]
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(Last)
(First)
(Middle)
C/O TAURIGA SCIENCES, INC., 39 OLD RIDGEBURY ROAD
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
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X
___ Officer (give title below)
_____ Other (specify below)
Chief Financial Officer /
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(Street)
DANBURY, CT 06180
(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)
_
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)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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20000000
(1)
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D
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Common Stock
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3000000
(2)
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I
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See footnote
(2)
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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)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Explanation of Responses:
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(1)
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The Registrant has agreed to issue the Reporting Person 20,000,000 of shares of Common Stock in partial consideration of the Reporting Person's service as the Registrant's Chief Financial Officer. These shares have not been issued as of the date hereof. All 20,000,000 shares of Common Stock will be "restricted securities" as defined by Rule 144 promulgated under the Securities Act of 1933, as amended.
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(2)
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These 3,000,000 shares of Common Stock were previously issued to Mariner Consulting Group, Inc. for accounting services previously provided to the Registrant. The Reporting Person is the sole shareholder and has voting control of Mariner Consulting Group, Inc. All 3,000,000 shares of Common Stock are "restricted securities" as defined by Rule 144 promulgated under the Securities Act of 1933, as amended.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Lacey Kevin Patrick
C/O TAURIGA SCIENCES, INC.
39 OLD RIDGEBURY ROAD
DANBURY, CT 06180
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Chief Financial Officer
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Signatures
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/s/ Kevin P. Lacey
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7/13/2017
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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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