Statement of Changes in Beneficial Ownership (4)
November 25 2019 - 4:57PM
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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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
*
Levine Jon R |
2. Issuer Name and Ticker or Trading Symbol
MARIMED INC.
[
MRMD
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner __X__ Officer (give title below) _____ Other (specify below) CFO, Treasurer and Secretary |
(Last)
(First)
(Middle)
C/O MARIMED INC., 10 OCEANA WAY |
3. Date of Earliest Transaction
(MM/DD/YYYY)
1/1/2016 |
(Street)
NORWOOD,, MA 02062
(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 | 6/30/2017 | | P | | 14807500 | A | (1) | 19635343 | D | |
Common stock | 6/30/2017 | | P | | 4687500 | A | (4) | 6684640 | I | By the Jon Levine Family Trust (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. 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 |
Option to buy common stock | $0.14 | 1/1/2016 | | A | | 350000 | | (2) | 12/31/2020 | Common Stock, par value $.001 per share | 350000 | (3) | 350000 | D | |
Option to buy common stock | $0.63 | 1/1/2017 | | A | | 100000 | | (2) | 12/31/2021 | Common Stock, par value $.001 per share | 100000 | (3) | 100000 | D | |
Explanation of Responses: |
(1) | The reporting person acquired the common stock in exchange for his ownership interest in MariMed Advisors Inc., a subsidiary of the issuer, having an estimated market value of approximately $3,702,000. |
(2) | Immediately. |
(3) | Not applicable. |
(4) | The common stock was acquired in exchange for the trust's ownership interest in MariMed Advisors Inc., a subsidiary of the issuer, having an estimated market value of approximately $1,172,000. |
(5) | These shares are held in trust for the benefit of the reporting person's spouse and children. The reporting person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Levine Jon R C/O MARIMED INC. 10 OCEANA WAY NORWOOD,, MA 02062 | X | X | CFO, Treasurer and Secretary |
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Signatures
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/s/ Jon R. Levine | | 11/25/2019 |
**Signature of Reporting Person | Date |
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