0001445866-16-003038.txt : 20161228 0001445866-16-003038.hdr.sgml : 20161228 20161228165045 ACCESSION NUMBER: 0001445866-16-003038 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161221 FILED AS OF DATE: 20161228 DATE AS OF CHANGE: 20161228 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Cannabis Sativa, Inc. CENTRAL INDEX KEY: 0001360442 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PERSONAL SERVICES [7200] IRS NUMBER: 201898270 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1646 W. PIONEER BLVD. STREET 2: SUITE 120 CITY: MESQUITE STATE: NV ZIP: 89027 BUSINESS PHONE: 702-346-3906 MAIL ADDRESS: STREET 1: 1646 W. PIONEER BLVD. STREET 2: SUITE 120 CITY: MESQUITE STATE: NV ZIP: 89027 FORMER COMPANY: FORMER CONFORMED NAME: Ultra Sun Corp DATE OF NAME CHANGE: 20060424 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gray James Polin CENTRAL INDEX KEY: 0001621404 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-53571 FILM NUMBER: 162072951 MAIL ADDRESS: STREET 1: 2531 CRESTVIEW DRIVE CITY: NEWPORT BEACH STATE: CA ZIP: 92663 4 1 form4.xml OWNERSHIP DOCUMENT X0306 4 2016-12-21 0 0001360442 Cannabis Sativa, Inc. CBDS 0001621404 Gray James Polin 2531 CRESTVIEW DRIVE NEWPORT BEACH CA 92663 1 0 0 0 Common Stock 2016-12-21 4 A 0 5000 0 A 29631 D Fully vested shares issued for services. /s/ James P. Gray 2016-12-21