SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Owen Shawn

(Last) (First) (Middle)
PO BOX 8350

(Street)
DENVER CO 80201

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/11/2021
3. Issuer Name and Ticker or Trading Symbol
Salt Blockchain Inc. [ SALT ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 103,151(1) D
Common Stock 1,651,146(1) I As Managing Member(2)
Common Stock 1,727,432(1) I As Majority Stockholder and CEO(3)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
Owen Shawn

(Last) (First) (Middle)
PO BOX 8350

(Street)
DENVER CO 80201

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Owen Enterprise, LLC

(Last) (First) (Middle)
1499 W. 120TH AVENUE
SUITE 110

(Street)
WESTMINSTER CO 80234

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Managing Member
1. Name and Address of Reporting Person*
Equa, Inc./CO

(Last) (First) (Middle)
1499 W. 120TH AVENUE
SUITE 110

(Street)
WESTMINSTER CO 80234

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Majority Stockholder and CEO
Explanation of Responses:
1. This Form 3 is being filed late due to delays in obtaining the reporting person's EDGAR codes.
2. Shares held of record by Owen Enterprise, LLC. Shawn Owen is the managing member of Owen Enterprise, LLC and may be deemed to beneficially own the shares held by this entity.
3. Shares held of record by Equa, Inc. Shawn Owen is the majority stockholder and CEO of Equa, Inc. and may be deemed to beneficially own the shares held by this entity.
/s/ Shawn Owen 08/17/2021
/s/ Shawn Owen, Managing Member of Owen Enterprise, LLC 08/17/2021
/s/ Shawn Owen, Majority Stockholder and CEO of Equa, Inc. 08/17/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.