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