0001445866-17-001451.txt : 20171017 0001445866-17-001451.hdr.sgml : 20171017 20171017162717 ACCESSION NUMBER: 0001445866-17-001451 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: Carroll Catherine J CENTRAL INDEX KEY: 0001581976 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-53571 FILM NUMBER: 171140953 MAIL ADDRESS: STREET 1: 450 HILLSIDE DRIVE A224 CITY: MESQUITE STATE: NV ZIP: 89027 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 0001581976 Carroll Catherine J 450 HILLSIDE DRIVE A224 MESQUITE NV 89027 1 1 0 0 Treasurer Common Stock 2017-10-06 4 A 0 5000 0 A 286610 D Common Stock 2017-10-06 4 A 0 5499 0 A 292109 I Footnote Shares held by Carroll's Consulting LLC. Fully vested shares issued for services through 09/30/17 Fully vested shares issued for services for quarter ended 9/30/17 /s/ Cathy Carroll 2017-10-17