1. Name and Address of Reporting Person*
5174 SONOMA MOUNTAIN ROAD |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
|
10% Owner |
|
Officer (give title below) |
X |
Other (specify below) |
|
|
|
Member of 10% owner group |
|
1. Name and Address of Reporting Person*
5174 SONOMA MOUNTAIN ROAD |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
|
10% Owner |
|
Officer (give title below) |
X |
Other (specify below) |
|
|
|
Member of 10% owner group |
|
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
|
10% Owner |
|
Officer (give title below) |
X |
Other (specify below) |
|
|
|
Member of 10% owner group |
|
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
|
10% Owner |
|
Officer (give title below) |
X |
Other (specify below) |
|
|
|
Member of 10% owner group |
|
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
|
10% Owner |
|
Officer (give title below) |
X |
Other (specify below) |
|
|
|
Member of 10% owner group |
|
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
|
10% Owner |
|
Officer (give title below) |
X |
Other (specify below) |
|
|
|
Member of 10% owner group |
|
|
/s/ Patrick D. Daugherty, attorney-in-fact for Marcia Mickelson |
06/17/2021 |
|
/s/ Patrick D. Daugherty, attorney-in-fact for James Martin Mickelson |
06/17/2021 |
|
A & L KUNDE TRUST #3 By: /s/ Patrick D. Daugherty, attorney-in-fact for Marcia Mickelson, Trustee |
06/17/2021 |
|
A KUNDE AND L KUNDE GST EXEMPT GRAT FBO MARCIA MICKELSON By: /s/ Patrick D. Daugherty, attorney-in-fact for Marcia Mickelson, Trustee |
06/17/2021 |
|
VOTING TRUST FBO MARCIA MICKELSON U/T KUNDE LIVING TRUST By: /s/ Patrick D. Daugherty, attorney-in-fact for Marcia Mickelson, Trustee |
06/17/2021 |
|
JIM & MARCIA MICKELSON LIVING TRUST DATED 4-11-01 By: /s/ Patrick D. Daugherty, attorney-in-fact for Marcia Mickelson, Trustee |
06/17/2021 |
|
JIM & MARCIA MICKELSON LIVING TRUST DATED 4-11-01 By: /s/ Patrick D. Daugherty, attorney-in-fact for James Martin Mickelson, Trustee |
06/17/2021 |
|
** 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. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |