0001628280-23-040571.txt : 20231204 0001628280-23-040571.hdr.sgml : 20231204 20231204115745 ACCESSION NUMBER: 0001628280-23-040571 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231117 FILED AS OF DATE: 20231204 DATE AS OF CHANGE: 20231204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cacioppo James CENTRAL INDEX KEY: 0001455939 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-56468 FILM NUMBER: 231461867 MAIL ADDRESS: STREET 1: 551 MADISON AVENUE STREET 2: 10TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Jushi Holdings Inc. CENTRAL INDEX KEY: 0001909747 STANDARD INDUSTRIAL CLASSIFICATION: MEDICINAL CHEMICALS & BOTANICAL PRODUCTS [2833] IRS NUMBER: 981547061 STATE OF INCORPORATION: A1 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 301 YAMATO ROAD STREET 2: SUITE 3250 CITY: BOCA RATON STATE: FL ZIP: 33431 BUSINESS PHONE: 5616179100 MAIL ADDRESS: STREET 1: 301 YAMATO ROAD STREET 2: SUITE 3250 CITY: BOCA RATON STATE: FL ZIP: 33431 4/A 1 wk-form4a_1701709055.xml FORM 4/A X0508 4/A 2023-11-17 2023-11-21 0 0001909747 Jushi Holdings Inc. JUSH/JUSHF 0001455939 Cacioppo James C/O JUSHI HOLDINGS INC. 301 YAMATO ROAD, SUITE 3250 BOCA RATON FL 33431 1 1 1 0 Chief Executive Officer 0 Stock Option (right to buy) 3.91 2023-11-17 4 D 0 3000000 D 2031-10-27 Subordinate Voting Shares 3000000 0 D One-third of the Option will vest on each of the first, second and third anniversaries of the Vesting Commencement Date (5/1/2021), subject to continuous service. On November 17, 2023, the issuer canceled, pursuant to the reporting person's employment agreement, an option for 3,000,000 shares of the issuer's Subordinate Voting Shares granted to the reporting person. Does not include options and warrants to purchase an aggregate of 29,490,551 Subordinated Voting Shares of different classes held directly or indirectly by such reporting person. For future filings, the reporting person intends to report in column 9 of Table II only the shares beneficially held of the same class for any reported transaction pursuant to SEC guidance. The purpose of this amendment is to correct the total derivative securities beneficially held of all classes, now included in footnote 3, to reflect that warrants to purchase 175,000 Subordinate Voting Shares of another class had previously expired on September 27, 2023. /s/ James Cacioppo 2023-12-04