0001731122-21-001314.txt : 20210806
0001731122-21-001314.hdr.sgml : 20210806
20210806144400
ACCESSION NUMBER: 0001731122-21-001314
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210630
FILED AS OF DATE: 20210806
DATE AS OF CHANGE: 20210806
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Chuang George T.
CENTRAL INDEX KEY: 0001873954
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40641
FILM NUMBER: 211152421
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
2021-06-30
0
0001762239
Kaival Brands Innovations Group, Inc.
KAVL
0001873954
Chuang George T.
4460 OLD DIXIE HIGHWAY
GRANT
FL
32949
1
0
0
0
Stock Options
0.7599
2021-06-30
4
A
0
300000
0.00
A
2031-06-30
Common Stock
300000
300000
D
90,000 shares vested on June 30, 2021. The remaining shares will vest in increments of 105,000 on June 30, 2022 and June 30, 2023. All unvested shares will automatically vest upon a "Change of Control," as that term is defined in the 2020 Stock and Incentive Compensation Plan. The stock options were adjusted for the Company's one-for-twelve reverse stock split effected on July 20, 2021 (see Footnote 2).
On July 20, 2021, the Company effected a one-for-twelve reverse stock split of its common stock. Accordingly, the option was automatically adjusted such that the number of shares underlying the option is 25,000, with 7,500 shares vested, and the remaining shares vesting in increments of 8,750 on June 30, 2022 and June 30, 2023. The conversion price per share is $9.1188.
/s/ Eric Mosser, as attorney-in-fact
2021-08-06