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