Statement of Changes in Beneficial Ownership (4)
February 05 2021 - 2:40PM
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
*
GLASHOW ANDREW |
2. Issuer Name and Ticker or Trading Symbol
CLS Holdings USA, Inc.
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CLSH
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) President & COO |
(Last)
(First)
(Middle)
1C BOWENS LANDING |
3. Date of Earliest Transaction
(MM/DD/YYYY)
7/27/2020 |
(Street)
NEWPORT, RI 02840
(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 | 7/27/2020 | | J(1) | | 700000 | D | (1) | 0 | I | See Footnote (1) |
Common Stock | | | | | | | | 500000 (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. 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) | The reported securities are held by Star Associates, LLC, a limited liability company previously owned by the Reporting Person. On July 27, 2020, the Reporting Person transferred 100% of his
membership interest in Star Associates, LLC, for no consideration, to a non-affiliate of the Issuer. |
(2) | Represents restricted shares of the Issuer's common stock, 250,000 shares of which vested on March 1, 2020 and 250,000 of which will vest on March 1, 2021, assuming that the Reporting Person
remains employed by the Issuer on such date or has been removed by the Issuer prior to such vesting date without cause. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
GLASHOW ANDREW 1C BOWENS LANDING NEWPORT, RI 02840 | X |
| President & COO |
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Signatures
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/s/ Andrew Glashow | | 2/5/2021 |
**Signature of Reporting Person | Date |
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