0001731122-22-000323.txt : 20220225 0001731122-22-000323.hdr.sgml : 20220225 20220225171500 ACCESSION NUMBER: 0001731122-22-000323 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210505 FILED AS OF DATE: 20220225 DATE AS OF CHANGE: 20220225 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Patel Nirajkumar CENTRAL INDEX KEY: 0001768756 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40641 FILM NUMBER: 22681853 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: RETAIL-NONSTORE RETAILERS [5960] 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 2021-05-05 0 0001762239 Kaival Brands Innovations Group, Inc. KAVL 0001768756 Patel Nirajkumar 4460 OLD DIXIE HIGHWAY, GRANT FL 32949 1 1 1 0 Chief Executive Officer Common Stock 2021-05-05 4 M 0 16667 0 A 96836 D Common Stock 2021-05-05 4 F 0 4059 14.52 D 92777 D Common Stock 2021-08-05 4 M 0 16667 0 A 109444 D Common Stock 2021-08-05 4 F 0 4059 6.26 D 105385 D Common Stock 2021-11-05 4 M 0 20833 0 A 126218 D Common Stock 2021-11-05 4 F 0 5073 1.80 D 121145 D Common Stock 2022-02-05 4 M 0 20833 0 A 141978 D Common Stock 2022-02-05 4 F 0 6177 0.97 D 135801 D Common Stock 17000000 I By Kaival Holdings, LLC Restricted Stock Units 2021-05-05 4 M 0 16667 0 D Common Stock 16667 179166 D Restricted Stock Units 2021-08-05 4 M 0 16667 0 D Common Stock 16667 162499 D Restricted Stock Units 2021-11-05 4 M 0 20833 0 D Common Stock 20833 141666 D Restricted Stock Units 2022-02-05 4 M 0 20833 0 D Common Stock 20833 120833 D The reporting person inadvertently reported receiving 12,500 shares of KAVL common stock on February 5, 2021 from the vesting of an RSU, instead of 16,667 shares of KAVL common stock. The starting balance reflects this correction. 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 250,000 restricted stock units. The restricted stock units vest over a three-year period, with a portion vesting immediately on the grant date, and the reminder partially vesting every three months. /s/ Eric Mosser, as attorney-in-fact 2022-02-25