0001445866-17-001113.txt : 20170801 0001445866-17-001113.hdr.sgml : 20170801 20170801114229 ACCESSION NUMBER: 0001445866-17-001113 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170630 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 SEC ACT: 1934 Act SEC FILE NUMBER: 000-53571 FILM NUMBER: 17995643 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 1 form4.xml OWNERSHIP DOCUMENT X0306 4 2017-06-30 0 0001360442 Cannabis Sativa, Inc. CBDS 0001621404 Gray James Polin 2531 CRESTVIEW DRIVE NEWPORT BEACH CA 92663 1 0 0 0 Common Stock 2017-06-30 4 A 0 5000 0 A 64144 D Common Stock 2017-07-26 4 A 0 5000 0 A 69144 D Fully vested shares issued for services through 3/31/17 Fully vested shares issued for services through 6/30/17 /s/ Jim Gray 2017-07-27