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