Initial Statement of Beneficial Ownership (3)
April 10 2020 - 4:24PM
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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Yorke Justin W |
2. Date of Event Requiring Statement (MM/DD/YYYY)
3/31/2020
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3. Issuer Name and Ticker or Trading Symbol
Canfield Medical Supply, Inc. [CNMF]
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(Last)
(First)
(Middle)
4120 BOARDMAN-CANFIELD ROAD |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
__X__ Director ___X___ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
Secretary / |
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(Street)
CANFIELD, OH 44406
(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) |
| Common Stock | 8436000 | I | By WesBev LLC (1) |
| Common Stock | 4194033 | I | By JMW Fund, LLC (1) |
| Common Stock | 3846436 | I | By San Gabriel Fund, LLC (1) |
| Common Stock | 2297436 | I | By Richland Fund, LLC (1) |
| Common Stock | 127840 | I | By San Gabriel Advisors, LLC PSP FBO Justin Yorke (1) |
| Common Stock | 249695 | I | By San Gabriel Advisors, LLC PSP FBO John McGrain (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 |
| Warrant (Right to Buy) | 3/31/2020 | 3/31/2023 | Common Stock | 35837 | $1.50 | I | By JMW Fund, LLC (1) |
| Warrant (Right to Buy) | 3/31/2020 | 3/31/2023 | Common Stock | 485774 | $0.25 | I | By JMW Fund, LLC (1) |
| Warrant (Right to Buy) | 3/31/2020 | 3/31/2023 | Common Stock | 31733 | $1.50 | I | By San Gabriel Fund, LLC (1) |
| Warrant (Right to Buy) | 3/31/2020 | 3/31/2023 | Common Stock | 438670 | $0.25 | I | By San Gabriel Fund, LLC (1) |
| Warrant (Right to Buy) | 3/31/2020 | 3/31/2023 | Common Stock | 17789 | $1.50 | I | By Richland Fund, LLC (1) |
| Warrant (Right to Buy) | 3/31/2020 | 3/31/2023 | Common Stock | 438478 | $0.25 | I | By Richland Fund, LLC (1) |
| Warrant (Right to Buy) | 3/31/2020 | 3/31/2023 | Common Stock | 3835 | $1.50 | I | By San Gabriel Advisors, LLC PSP FBO Justin Yorke (1) |
| Warrant (Right to Buy) | 3/31/2020 | 3/31/2023 | Common Stock | 7470 | $1.50 | I | By San Gabriel Advisors, LLC PSP FBO John McGrain (1) |
| Explanation of Responses: |
| (1) | Mr. Yorke is a manager of WesBev LLC, JMW Fund LLC, San Gabriel Fund LLC, Richland Fund LLC, San Gabriel Advisors, LLC PSP FBO Justin Yorke, and San Gabriel Advisors, LLC PSP FBO John McGrain, and as a result may be deemed to be the beneficial owner of securities listed in this Form 3. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Yorke Justin W
4120 BOARDMAN-CANFIELD ROAD
CANFIELD, OH 44406 | X | X | Secretary |
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Signatures
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| /s/ Justin Yorke | | 4/10/2020 |
| **Signature of Reporting Person | Date |