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