Initial Statement of Beneficial Ownership (3)

Date : 07/29/2019 @ 6:54PM
Source : Edgar (US Regulatory)
Stock : Exactus, Inc. (EXDI)
Quote : 0.63  -0.0699 (-9.99%) @ 7:14PM

Initial Statement of Beneficial Ownership (3)

FORM 3
        
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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
                      

1. Name and Address of Reporting Person *

Yampolsky Vladislav

2. Date of Event Requiring Statement (MM/DD/YYYY)
6/24/2019 

3. Issuer Name and Ticker or Trading Symbol

Exactus, Inc. [EXDI]

(Last)        (First)        (Middle)

80 NE 4TH AVENUE STE 28

4. Relationship of Reporting Person(s) to Issuer (Check all applicable)

__ X __ Director                            ___ X ___ 10% Owner
_____ Officer (give title below)          _____ Other (specify below)

(Street)

DELRAY BEACH, FL 33483       

(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


Table I - Non-Derivative Securities Beneficially Owned
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   7635690   (1) I   See footnote  

Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities)
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
Option (Right to Purchase)   1/9/2019   (2) 1/8/2029   Common Stock   250000   $0.32   D  
 

Explanation of Responses:
(1)  Includes shares owned by Ceed2Med, LLC of which the Reporting Person is the Manager and, in that capacity, has the right to vote and dispose of such shares of common stock. Excludes 0% convertible preferred stock issuable to Ceed2Med, LLC which contain a 4.99% beneficial ownership blocker.
(2)  The options vest in equal monthly installments over a two year period starting on January 8, 2019.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director 10% Owner Officer Other
Yampolsky Vladislav
80 NE 4TH AVENUE STE 28
DELRAY BEACH, FL 33483
X X


Signatures
/s/ Vladislav Yampolsky 7/29/2019
** 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.

Exactus, Inc. (USOTC:EXDI)
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