0001104659-21-146934.txt : 20211206
0001104659-21-146934.hdr.sgml : 20211206
20211206214600
ACCESSION NUMBER: 0001104659-21-146934
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211203
FILED AS OF DATE: 20211206
DATE AS OF CHANGE: 20211206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Roth Byron
CENTRAL INDEX KEY: 0001810078
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41105
FILM NUMBER: 211474549
MAIL ADDRESS:
STREET 1: 888 SAN CLEMENTE DRIVE
STREET 2: SUITE 400
CITY: NEWPORT BEACH
STATE: CA
ZIP: 92660
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Roth CH Acquisition V Co.
CENTRAL INDEX KEY: 0001885998
STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770]
IRS NUMBER: 861229207
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 888 SAN CLEMENTE DRIVE SUITE 400
CITY: NEWPORT BEACH
STATE: CA
ZIP: 92660
BUSINESS PHONE: 9497205700
MAIL ADDRESS:
STREET 1: 888 SAN CLEMENTE DRIVE SUITE 400
CITY: NEWPORT BEACH
STATE: CA
ZIP: 92660
4
1
tm2134740-5_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2021-12-03
0
0001885998
Roth CH Acquisition V Co.
ROCLU
0001810078
Roth Byron
C/O ROTH CH ACQUISITION V CO.
888 SAN CLEMENTE DRIVE, SUITE 400
NEWPORT BEACH
CA
92660
1
1
0
0
Co-CEO & Co-Chairman of Board
Common Stock
2021-12-03
4
P
0
67163
10
A
481295
D
Common Stock
2021-12-03
4
P
0
106559
10
A
763615
I
See Footnote
Warrants to purchase Common Stock
11.50
2021-12-03
4
P
0
33581
A
Common Stock
33581
33581
D
Warrants to purchase Common Stock
11.50
2021-12-03
4
P
0
53279
A
Common Stock
53279
53279
I
See Footnote
The reporting person acquired units, each unit consisting of one share of common stock and one-half of one warrant.
Owned by CR Financial Holdings, Inc., over which Byron Roth and Gordon Roth have voting and dispositive power.
The warrants become exercisable 30 days after the consummation of the registrant's initial business combination offering.
The warrants expire 5 years after the completion of the registrant's initial business combination or earlier upon redemption or liquidation, as described in the registrant's prospectus filed with the SEC.
By: /s/ Byron Roth
2021-12-06