0001128732-17-000021.txt : 20170717
0001128732-17-000021.hdr.sgml : 20170717
20170717090501
ACCESSION NUMBER: 0001128732-17-000021
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170607
FILED AS OF DATE: 20170717
DATE AS OF CHANGE: 20170717
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Williams Andrew Johns
CENTRAL INDEX KEY: 0001654836
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55450
FILM NUMBER: 17966742
MAIL ADDRESS:
STREET 1: 3163 W. 105TH COURT
CITY: WESTMINSTER
STATE: CO
ZIP: 80031
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Medicine Man Technologies, Inc.
CENTRAL INDEX KEY: 0001622879
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT CONSULTING SERVICES [8742]
IRS NUMBER: 465289499
STATE OF INCORPORATION: NV
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4880 HAVANA STREET
STREET 2: SUITE 102 SOUTH
CITY: DENVER
STATE: CO
ZIP: 80239
BUSINESS PHONE: 303-371-0387
MAIL ADDRESS:
STREET 1: 4880 HAVANA STREET
STREET 2: SUITE 102 SOUTH
CITY: DENVER
STATE: CO
ZIP: 80239
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2017-06-07
0
0001622879
Medicine Man Technologies, Inc.
MDCL
0001654836
Williams Andrew Johns
3163 W. 105TH COURT
WESTMINSTER
CO
80031
1
0
1
0
Common Stock
2017-06-07
4
A
0
375000
0.93
A
375000
I
Held in the name of Andrew Johns Williams Revocable Trust Dated May 28, 2015
Common Stock Warrants
1.445
2017-06-07
4
A
0
750000
0
A
2017-06-07
2019-12-31
Common Stock
750000
750000
I
Held in the name of Andrew Johns Williams Revocable Trust Dated May 28, 2015
Reporting Person received shares of restricted Common Stock issued pursuant to the terms of the Issuer's 2017 Equity Incentive Plan.
Reporting Person is the Trustee of the Andrew Johns Williams Revocable Trust Dated May 28, 2015 and, as such, has dispositive power over the shares.
Andrew Johns Williams
2017-07-17