0001493152-22-001279.txt : 20220114 0001493152-22-001279.hdr.sgml : 20220114 20220114162017 ACCESSION NUMBER: 0001493152-22-001279 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211228 FILED AS OF DATE: 20220114 DATE AS OF CHANGE: 20220114 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Levine Jon R CENTRAL INDEX KEY: 0001789645 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54433 FILM NUMBER: 22532098 MAIL ADDRESS: STREET 1: C/O MARIMED INC. STREET 2: 10 OCEANA WAY CITY: NORWOOD STATE: MA ZIP: 02062 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MARIMED INC. CENTRAL INDEX KEY: 0001522767 STANDARD INDUSTRIAL CLASSIFICATION: MEDICINAL CHEMICALS & BOTANICAL PRODUCTS [2833] IRS NUMBER: 274672745 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 26 OSSIPEE RD STREET 2: SUITE 201 CITY: NEWTON STATE: MA ZIP: 02464 BUSINESS PHONE: 617-795-5140 MAIL ADDRESS: STREET 1: 26 OSSIPEE RD STREET 2: SUITE 201 CITY: NEWTON STATE: MA ZIP: 02464 FORMER COMPANY: FORMER CONFORMED NAME: WORLDS ONLINE INC. DATE OF NAME CHANGE: 20110608 4 1 ownership.xml X0306 4 2021-12-28 0 0001522767 MARIMED INC. MRMD 0001789645 Levine Jon R C/O MARIMED INC. 10 OCEANA WAY NORWOOD, MA 02062 1 1 0 0 CFO, Treasurer and Secretary Common stock 2021-12-28 4 M 0 100000 0.63 A 20085343 D Common stock 2021-12-28 4 F 0 76226 0.86 D 20012117 D Common stock 6684640 I By the Jon Levine Family Trust Option to buy common stock 0.63 2021-12-28 4 M 0 100000 0 D 2021-12-31 Common Stock, par value $.001 per share 100000 0 D Option to buy common stock 0.898 2026-10-01 Common Stock, par value $.001 per share 5000000 5000000 D Option to buy common stock 0.88 2026-07-09 Common Stock, par value $.001 per share 5000000 5000000 D These shares are held in trust for the benefit of the reporting person's spouse and children. The reporting person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. Immediately. Exercisable to acquire 50% of the underlying shares on the July 9, 2021 and 100% of the shares on or after July 9, 2022. /s/ Jon R. Levine 2022-01-14