0001829126-24-002732.txt : 20240423
0001829126-24-002732.hdr.sgml : 20240423
20240423213026
ACCESSION NUMBER: 0001829126-24-002732
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240420
FILED AS OF DATE: 20240423
DATE AS OF CHANGE: 20240423
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Liu Dong
CENTRAL INDEX KEY: 0001813729
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41062
FILM NUMBER: 24866538
MAIL ADDRESS:
STREET 1: 311 WEST 43RD STREET, 12TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mountain Crest Global Holdings LLC
CENTRAL INDEX KEY: 0001859046
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41062
FILM NUMBER: 24866539
BUSINESS ADDRESS:
STREET 1: 311 WEST 43RD STREET, 12TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
BUSINESS PHONE: 646-493-6558
MAIL ADDRESS:
STREET 1: 311 WEST 43RD STREET, 12TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Mountain Crest Acquisition Corp. V
CENTRAL INDEX KEY: 0001859035
STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770]
ORGANIZATION NAME: 05 Real Estate & Construction
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 311 WEST 43RD STREET, 12TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
BUSINESS PHONE: 646-493-6558
MAIL ADDRESS:
STREET 1: 311 WEST 43RD STREET, 12TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
4
1
ownership.xml
FORM 4
X0508
4
2024-04-20
0
0001859035
Mountain Crest Acquisition Corp. V
MCAG
0001859046
Mountain Crest Global Holdings LLC
311 WEST 43RD STREET, 12TH FLOOR
NEW YORK
NY
10036
0
0
1
0
0001813729
Liu Dong
311 WEST 43RD STREET, 12TH FLOOR
NEW YORK
NY
10036
0
0
1
0
0
Common Stock
2024-04-20
4
J
0
150000
A
2165800
D
On October 30, 2023, Mountain Crest Acquisition Corp. V (the "Company") issued a non-interest bearing, unsecured promissory note in the aggregate principal amount of upto $400,000 to the Reporting Person. On April 3, 2024, the Company issued a non-interest bearing, unsecured promissory note in the aggregate principal amount of upto $300,000 to the Reporting Person. As of April 15, 2024, the principal amount outstanding under the notes is $600,000. On April 19, 2024, as approved by the Company's audit committee, the Company entered into a note conversion agreement (the "Note Conversion Agreement") with the Reporting Person, to convert the principal amount of the Note into 150,000 shares of the Company's Common Stock at $4:00 per share. On April 20, 2024, the Company issued 150,000 shares to the Reporting Person in satisfaction of the notes.
The Shares are owned by Mountain Crest Global Holdings LLC, and Dong Liu, the sole manager of Mountain Crest Global Holdings LLC, has sole voting and dispositive power over the shares owned by Mountain Crest Global Holdings LLC.
By: /s/ Dong Liu Name: Dong Liu Title: Manager
2024-04-23
By: /s/ Dong Liu
2024-04-23