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