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
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1. Name and Address of Reporting Person*
Kovler Benjamin

(Last) (First) (Middle)
325 WEST HURON STREET
SUITE 412

(Street)
CHICAGO IL 60654

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/18/2020
3. Issuer Name and Ticker or Trading Symbol
Green Thumb Industries Inc. [ GTII/GTBIF ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman & CEO
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)
Subordinate Voting Shares 145,004 D
Subordinate Voting Shares 57,418 I By RCP23 LLC
Subordinate Voting Shares 8 I By GTI II LLC
Subordinate Voting Shares 71 I By daughter
Subordinate Voting Shares 71 I By daughter
Subordinate Voting Shares 46 I By Outsiders Capital LLC
Multiple Voting Shares 43,534 I By GTI II LLC
Multiple Voting Shares 96,885 I By RCP23 LLC
Super Voting Shares 11,808 I By GTI II LLC
Super Voting Shares 107,368 I By RCP23 LLC
Super Voting Shares 91,665 D
Super Voting Shares 59,474 I By Outsiders Capital LLC
Super Voting Shares 170 I By daughter
Super Voting Shares 170 I By daughter
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
Employee Stock Options 08/28/2019(1) 08/30/2028 Subordinate Voting Shares 50,000(1) $14.64(2) D
Employee Stock Options 07/26/2020(3) 07/26/2024 Subordinate Voting Shares 300,000(3) $12.07(2) D
Explanation of Responses:
1. The stock option was granted on 8/30/2018 and vests in one third increments annually over a three-year period beginning on the first anniversary of the grant date.
2. Exercise price is denominated and reported in Canadian dollars.
3. The stock option was granted on 7/26/2019 and vests in one third increments annually over a three-year period beginning on the first anniversary of the grant date.
/s/ Kathryn A Lloyd, Attorney-in-Fact 02/17/2020
** 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.
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