Initial Statement of Beneficial Ownership (3)
October 16 2019 - 2:11PM
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
*
Georgens Andrew |
2. Date of Event Requiring Statement (MM/DD/YYYY)
10/9/2019
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3. Issuer Name and Ticker or Trading Symbol
B2Digital, Inc. [BTDG]
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(Last)
(First)
(Middle)
14426 W. MORNING STAR TRAIL |
4. 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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(Street)
SURPRISE, AZ 85374
(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 | 1022880 | D | |
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 |
Series A Preferred | 12/17/2016 | (1) | Common Stock | 24000000 | (2) | D | |
Explanation of Responses: |
(1) | The holder of Series A Preferred Stock may convert at any time into shares of Common Stock. |
(2) | Mr. Georgens owns 100,000 shares of Series A Preferred Stock which are convertible into 240 shares of Common Stock per share of Series A Preferred Stock. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Georgens Andrew 14426 W. MORNING STAR TRAIL SURPRISE, AZ 85374 | X |
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Signatures
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/s/ Andrew Georgens | | 10/16/2019 |
**Signature of Reporting Person | Date |
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