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
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Jensen Lindsey

(Last) (First) (Middle)
1222 N PENNSYLVANIA ST
UNIT B

(Street)
DENVER CO 80203

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/01/2022
3. Issuer Name and Ticker or Trading Symbol
Charlotte's Web Holdings, Inc. [ CWBHF ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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 Shares 6,272 D
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
Stock Option (right to buy) (1) 03/26/2030 Common Shares 9,442 $4.78 D
Stock Option (right to buy) (2) 03/26/2031 Common Shares 9,604 $4.7 D
Stock Option (right to buy) (3) 02/11/2032 Common Shares 52,500 $1.56 D
Restricted Stock Unit (4) (4) Common Shares 573 (5) D
Restricted Stock Unit (6) (6) Common Shares 17,500 (5) D
Restricted Stock Unit (7) (7) Common Shares 5,278 (5) D
Restricted Stock Unit (8) (8) Common Shares 21,929 (5) D
Restricted Stock Unit (9) (9) Common Shares 49,669 (5) D
Explanation of Responses:
1. The option agreement provides that the option becomes exercisable in 3 equal annual installments beginning on the first anniversary of the option's grant date. The option was granted on 3/26/2020.
2. The option agreement provides that the option becomes exercisable in 4 equal annual installments beginning on the first anniversary of the option's grant date. The option was granted on 3/26/2021.
3. The option agreement provides that the option becomes exercisable in 3 equal annual installments beginning on the first anniversary of the option's grant date. The option was granted on 2/11/2022.
4. The restricted share unit agreement provides that the restricted share unit vests in 3 equal annual installments beginning on the first anniversary of the restricted share unit's grant date. The restricted share unit was granted on 3/26/2020.
5. Each restricted stock unit represents a contingent right to receive one common share of Charlotte's Web Holdings, Inc.
6. The restricted share unit agreement provides that the restricted share unit vests in 3 equal annual installments beginning on the first anniversary of the restricted share unit's grant date. The restricted share unit was granted on 2/11/2022.
7. The restricted share unit agreement provides that the restricted share unit vests in 4 equal annual installments beginning on the first anniversary of the restricted share unit's grant date. The restricted share unit was granted on 3/26/2021.
8. The restricted share unit agreement provides that the restricted share unit vests in 1 equal annual installment on 7/1/2022. The restricted share unit was granted on 2/22/2022.
9. The restricted share unit agreement provides that the restricted share unit vests in 1 equal annual installment beginning on the second anniversary of the restricted share unit's grant date. The restricted share unit was granted on 11/19/2021.
Remarks:
/s/ Stephen D. Rogers, Attorney-in-Fact for Lindsey Jensen 05/09/2022
** 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.