0001213900-21-056832.txt : 20211104 0001213900-21-056832.hdr.sgml : 20211104 20211104184732 ACCESSION NUMBER: 0001213900-21-056832 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211029 FILED AS OF DATE: 20211104 DATE AS OF CHANGE: 20211104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Vu Quan Anh CENTRAL INDEX KEY: 0001892297 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38105 FILM NUMBER: 211381654 MAIL ADDRESS: STREET 1: 22616 ERWIN STREET CITY: WOODLAND HILLS STATE: CA ZIP: 91367 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: 180 Life Sciences Corp. CENTRAL INDEX KEY: 0001690080 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 813832378 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 830 MENLO AVENUE, SUITE 100 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-507-0669 MAIL ADDRESS: STREET 1: 830 MENLO AVENUE, SUITE 100 CITY: MENLO PARK STATE: CA ZIP: 94025 FORMER COMPANY: FORMER CONFORMED NAME: KBL MERGER CORP. IV DATE OF NAME CHANGE: 20161115 3 1 ownership.xml X0206 3 2021-10-29 0 0001690080 180 Life Sciences Corp. ATNF 0001892297 Vu Quan Anh 22616 ERWIN STREET WOODLAND HILLS CA 91367 0 1 0 0 COO / Chief Business Officer Common Stock 8000 D Effective on October 29, 2021, the Reporting Person was appointed as Chief Operating Officer / Chief Business Officer of the Issuer. /s/ Quan Anh Vu 2021-11-04