Statement of Changes in Beneficial Ownership (4)
September 16 2021 - 7:13PM
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
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3235-0287
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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
*
Kovacevich Nicholas |
2. Issuer Name and Ticker or Trading Symbol
Unrivaled Brands, Inc.
[
UNRV
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O UNRIVALED BRANDS, INC., 3242 HALLADAY ST., SUITE 202 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
9/14/2021 |
(Street)
SANTA ANA, CA 92705
(City)
(State)
(Zip)
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4. 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 Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 9/14/2021 | | A | | 1500000 (1) | A | $0.267 | 2150000 | D | |
Common Stock | | | | | | | | 955459 | I | By Trust |
Common Stock | | | | | | | | 19260742 | I | By Alpha West Holdings, Inc. (2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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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 |
Explanation of Responses: |
(1) | Represents 1,500,000 shares of restricted Common Stock granted pursuant to the Company's Amended and Restated 2018 Equity Incentive Plan, which are subject to a risk of forfeiture until vested. The 1,500,000 shares of restricted Common Stock vest in five equal installments, with the first installment vesting on September 14, 2021, and the remaining installments vesting on January 1, 2022, April 1, 2022, July 1, 2022 and October 1, 2022; provided the Reporting Person is a director of the Company on the applicable vesting date. |
(2) | Represents securities held by Alpha West Holdings, Inc., of which the Reporting Person is a stockholder. The Reporting Person disclaims beneficial ownership of these securities except to the extent of the Reporting Person's pecuniary interest therein. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Kovacevich Nicholas C/O UNRIVALED BRANDS, INC. 3242 HALLADAY ST., SUITE 202 SANTA ANA, CA 92705 | X |
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Signatures
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/s/ Nicholas Kovacevich | | 9/16/2021 |
**Signature of Reporting Person | Date |
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