0001213900-20-043289.txt : 20201217 0001213900-20-043289.hdr.sgml : 20201217 20201217172959 ACCESSION NUMBER: 0001213900-20-043289 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201214 FILED AS OF DATE: 20201217 DATE AS OF CHANGE: 20201217 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KRAUSS MARLENE CENTRAL INDEX KEY: 0001033308 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38105 FILM NUMBER: 201397177 MAIL ADDRESS: STREET 1: C/O KBL HEALTHCARE INC STREET 2: 645 MADISON AVE CITY: NEW YORK STATE: NY ZIP: 10022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KBL IV SPONSOR LLC CENTRAL INDEX KEY: 0001706868 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38105 FILM NUMBER: 201397178 BUSINESS ADDRESS: STREET 1: 527 STANTON CHRISTIANA ROAD CITY: NEWARK STATE: DE ZIP: 19713 BUSINESS PHONE: 3025022727 MAIL ADDRESS: STREET 1: 527 STANTON CHRISTIANA ROAD CITY: NEWARK STATE: DE ZIP: 19713 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: 180 Life Sciences Corp. CENTRAL INDEX KEY: 0001690080 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 813832378 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 150 WEST 56TH STREET SUITE 5901 CITY: NEW YORK STATE: NY ZIP: 10019 BUSINESS PHONE: 212-319-5555 MAIL ADDRESS: STREET 1: 150 WEST 56TH STREET SUITE 5901 CITY: NEW YORK STATE: NY ZIP: 10019 FORMER COMPANY: FORMER CONFORMED NAME: KBL MERGER CORP. IV DATE OF NAME CHANGE: 20161115 4 1 ownership.xml X0306 4 2020-12-14 0 0001690080 180 Life Sciences Corp. ATNF 0001033308 KRAUSS MARLENE 30 PARK PLACE, SUITE 64B NEW YORK NY 10007 0 0 1 0 0001706868 KBL IV SPONSOR LLC 30 PARK PLACE, SUITE 64B NEW YORK NY 10007 0 0 1 0 Common Stock 2020-12-17 4 S 0 12103 2.49 D 2006858 I See footnote Common Stock 2020-12-17 4 S 0 4403 2.44 D 2018961 I See footnote Common Stock 2020-12-16 4 J 0 334608 0.00 A 334608 D Common Stock 2020-12-16 4 J 0 520312 0.00 D 2023364 I See footnote Common Stock 2020-12-15 4 S 0 17877 2.40 D 2543676 I See footnote Common Stock 2020-12-14 4 S 0 10000 2.45 D 2561553 I See footnote The securities are held directly by KBL IV Sponsor LLC ("KBL Sponsor"). Dr. Marlene Krauss, the former Chief Executive Officer, and a former member of the Board of Directors, of the issuer, is the sole managing member of KBL Sponsor. Consequently, she may be deemed the beneficial owner of the securities of the issuer held by KBL Sponsor, and she has sole voting and dispositive control over such securities. Dr. Krauss disclaims beneficial ownership over any securities of the issuer owned by KBL Sponsor in which she does not have a pecuniary interest. KBL Sponsor made a pro rata distribution for no consideration of an aggregate of 520,312 shares of the common stock of the issuer to its members on December 16, 2020. Represents 334,608 shares of the issuer's common stock that were received by Dr. Krauss in a pro rata distribution made by KBL Sponsor to its members on December 16, 2020. In prior reports, Dr. Krauss reported indirect beneficial ownership of all of the shares of the issuer's common stock held by KBL Sponsor. /s/ Marlene Krauss, M.D. 2020-12-17 /s/ Marlene Krauss, M.D., as Managing Member of KBL IV SPONSOR LLC 2020-12-17