0001445866-17-001111.txt : 20170801
0001445866-17-001111.hdr.sgml : 20170801
20170801114056
ACCESSION NUMBER: 0001445866-17-001111
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150223
FILED AS OF DATE: 20170801
DATE AS OF CHANGE: 20170801
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Gray James Polin
CENTRAL INDEX KEY: 0001621404
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-53571
FILM NUMBER: 17995639
MAIL ADDRESS:
STREET 1: 2531 CRESTVIEW DRIVE
CITY: NEWPORT BEACH
STATE: CA
ZIP: 92663
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
4/A
1
form4.xml
OWNERSHIP DOCUMENT
X0306
4/A
2015-02-23
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
2015-02-23
4
A
0
12500
A
37131
D
Common Stock
2015-05-22
4
P
0
500
2.95
A
37631
D
Common Stock
2015-05-22
4
P
0
1513
2.97
A
39144
D
Common Stock
2016-06-30
4
A
0
10000
A
49144
D
Common Stock
2016-09-26
4
A
0
5000
A
54144
D
Common Stock
2016-12-21
4
A
0
5000
A
59144
D
Shares issued for services as director. 2,500 shares vested on each of the following dates: 12/31/14; 3/31/15; 6/30/15; 9/30/15; 12/31/15.
Shares issued for services as director. 5,000 shares vested on 3/31/16 and 5,000 vested on 6/30/16.
Shares issued for services as director. Shares vested on 9/30/16.
Fully vested shares issued for services.
/s/ James P. Gray
2017-07-31