0001731122-21-000532.txt : 20210406 0001731122-21-000532.hdr.sgml : 20210406 20210406204211 ACCESSION NUMBER: 0001731122-21-000532 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201105 FILED AS OF DATE: 20210406 DATE AS OF CHANGE: 20210406 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mosser Eric CENTRAL INDEX KEY: 0001768676 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-56016 FILM NUMBER: 21810436 MAIL ADDRESS: STREET 1: 4460 OLD DIXIE HIGHWAY CITY: GRANT STATE: FL ZIP: 32949 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Kaival Brands Innovations Group, Inc. CENTRAL INDEX KEY: 0001762239 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 833492907 FISCAL YEAR END: 1031 BUSINESS ADDRESS: STREET 1: 4460 OLD DIXIE HIGHWAY CITY: GRANT STATE: FL ZIP: 32949 BUSINESS PHONE: (833) 452-4825 MAIL ADDRESS: STREET 1: 4460 OLD DIXIE HIGHWAY CITY: GRANT STATE: FL ZIP: 32949 FORMER COMPANY: FORMER CONFORMED NAME: Quick Start Holdings, Inc. DATE OF NAME CHANGE: 20181218 4 1 ownership.xml X0306 4 2020-11-05 0 0001762239 Kaival Brands Innovations Group, Inc. KAVL 0001768676 Mosser Eric 4460 OLD DIXIE HIGHWAY GRANT FL 32949 1 1 1 0 Chief Operating Officer Common Stock 2020-11-05 4 M 0 150000 0 A 397428 D Common Stock 2020-11-05 4 F 0 125000 0.316 D 272428 D Common Stock 2021-01-01 4 A 0 75000 0 A 347428 D Common Stock 2021-02-05 4 M 0 150000 0 A 497428 D Common Stock 2021-02-05 4 F 0 19452 1.34 D 477976 D Common Stock 204000000 I By Kaival Holdings, LLC Restricted Stock Units 2020-11-05 4 M 0 150000 0 D Common Stock 150000 2550000 D Restricted Stock Units 2021-02-05 4 M 0 150000 0 D Common Stock 150000 2400000 D The reporting person was previously granted an equity award of 75,000 restricted shares of KAVL's common stock for every $50,000,000 in accumulated gross revenues generated. 75,000 shares vested on January 1, 2021 upon satisfaction of the performance criteria. Each restricted stock unit represents a contingent right to receive one share of KAVL's common stock. On May 28, 2020, the reporting person was granted 3,000,000 restricted stock units. The restricted stock units vest over a three-year period, with a portion vesting immediately on the grant date, and the remainder partially vesting every three months. /s/ Eric Mosser 2021-04-06