0001445866-17-001443.txt : 20171017
0001445866-17-001443.hdr.sgml : 20171017
20171017162127
ACCESSION NUMBER: 0001445866-17-001443
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171006
FILED AS OF DATE: 20171017
DATE AS OF CHANGE: 20171017
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Gravel Mike
CENTRAL INDEX KEY: 0001621792
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-53571
FILM NUMBER: 171140914
MAIL ADDRESS:
STREET 1: 4467 OCEAN HEIGHTS CT,
CITY: SEASIDE
STATE: CA
ZIP: 93955
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
2017-10-06
0
0001360442
Cannabis Sativa, Inc.
CBDS
0001621792
Gravel Mike
4467 OCEAN HEIGHTS CT,
SEASIDE
CA
93955
1
1
0
0
CEO
Common Stock
2017-10-06
4
A
0
5000
0
A
96408
D
Common Stock
2017-10-06
4
A
0
21416
0
A
117824
D
Common Stock
2017-10-06
4
A
0
100000
0
A
217824
D
Fully vested shares issued for services through 09/30/17
Fully vested shares issued for services 1/01/17 to 9/30/17
Fully vested shares issued for services. The shares were fully vested on 4/01/17 pursuant to the agreement for the period of 4/01/17 - 3/31/18
/s/ Mike Gravel
2017-10-17