Initial Statement of Beneficial Ownership (3)
March 11 2022 - 4:17PM
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
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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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Jennings Michael Lanteri |
2. Date of Event Requiring Statement (MM/DD/YYYY)
3/2/2022
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3. Issuer Name and Ticker or Trading Symbol
Planet 13 Holdings Inc. [PLTH/PLNHF]
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(Last)
(First)
(Middle)
2548 WEST DESERT INN ROAD, SUITE 100 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) Pres. of East Coast Operations / |
(Street)
LAS VEGAS, NV 89109
(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 Shares | 2862500 (1)(2) | 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 |
Stock Option | (3) | 7/6/2025 | Common Shares | 97325 (2) | $1.04 (4) | D | |
Stock Option | (5) | 9/30/2026 | Common Shares | 22900 (2) | $3.45 (6) | D | |
Explanation of Responses: |
(1) | Received in exchange for 25,000,000 common shares of Next Green Wave Holdings Inc. ("NGW") pursuant to the Arrangement Agreement between NGW and Planet 13 Holdings Inc. ("Planet 13") (the "Arrangement"). On March 2, 2022, the effective date of the Arrangement, the closing price of Planet 13's common shares on the Canadian Stock Exchange was C$3.34 per share. |
(2) | Received pursuant to Rule 16b-3(d). |
(3) | Fully vested on March 2, 2022. |
(4) | The exercise price reported above was converted from the Canadian exercise price of C$1.32 using an exchange rate of C$1.2668=US$1.00 on March 2, 2022. |
(5) | Fully vested on March 2, 2022. |
(6) | The exercise price reported above was converted from the Canadian exercise price of C$4.37 using an exchange rate of C$1.2668=US$1.00 on March 2, 2022. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Jennings Michael Lanteri 2548 WEST DESERT INN ROAD SUITE 100 LAS VEGAS, NV 89109 |
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| Pres. of East Coast Operations |
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Signatures
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/s/ Michael Jennings | | 3/11/2022 |
**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. |
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