0001683168-22-004385.txt : 20220615
0001683168-22-004385.hdr.sgml : 20220615
20220615194239
ACCESSION NUMBER: 0001683168-22-004385
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220614
FILED AS OF DATE: 20220615
DATE AS OF CHANGE: 20220615
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mukharji Pratap Chandra
CENTRAL INDEX KEY: 0001858854
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55450
FILM NUMBER: 221019072
MAIL ADDRESS:
STREET 1: 4880 HAVANA STREET
STREET 2: SUITE 201
CITY: DENVER
STATE: CO
ZIP: 80239
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 201 SOUTH
CITY: DENVER
STATE: CO
ZIP: 80239
BUSINESS PHONE: 303-371-0387
MAIL ADDRESS:
STREET 1: 4880 HAVANA STREET
STREET 2: SUITE 201 SOUTH
CITY: DENVER
STATE: CO
ZIP: 80239
4
1
ownership.xml
X0306
4
2022-06-14
0
0001622879
Medicine Man Technologies, Inc.
SHWZ
0001858854
Mukharji Pratap Chandra
C/O MEDICINE MAN TECHNOLOGIES, INC.
4880 HAVANA ST., STE. 201
DENVER
CO
80239
1
0
0
0
Common Stock
2022-06-14
4
A
0
22728
A
87701
D
Common Stock
39683
I
See Footnote
Employee Stock Option (Right to Buy)
1.72
2022-06-14
4
D
0
20349
D
2022-05-04
2029-05-03
Common Stock
20349
0
D
On May 4, 2022, the issuer granted to the reporting person options to purchase shares of Common Stock with an aggregate value of $35,000 as compensation for service on its board of directors. On June 14, 2022, the issuer and the reporting person agreed to cancel these options in exchange for shares of Common Stock with an aggregate value of $35,000.
Magnolia Hall Enterprises, LLC (the "Holder") is the record holder of the reported shares. Mr. Mukharji is the manager and 100% owner of the Holder and has voting and investment control of the shares held by the Holder.
The cancelled option vested 100% on the grant date.
/s/Daniel R. Pabon, attorney-in-fact for Pratap C. Mukharji
2022-06-15