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*
Stawski Scott A.

(Last) (First) (Middle)
6501 RED HOOK PLAZA, SUITE 201-465

(Street)
ST. THOMAS VI 00802

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/13/2024
3. Issuer Name and Ticker or Trading Symbol
Amphitrite Digital Inc [ AMDI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Executive Chairman
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)
Common Stock 6,875,200 D
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
Explanation of Responses:
Remarks:
Hope A. Stawski and Scott A Stawski are husband and wife and in aggregate own 6,875,200 shares of Common Stock as joint tenants in common. Hope A. Stawski has been issued 3,475,000 shares of Common Stock, of which (i) 3,200,000 shares were received on April 1, 2022, as the Founder, and (ii) 50,000 shares were received on August 5, 2022, in exchange for $50,000, as part of the Form C offering and 75,000 were received on April 1, 2023 per her employment contract. Hope A Stawski and her son, Henry M. Stawski, own jointly 150,000 shares of Common Stock issued as Founder on April 1, 2022. Scott A Stawski has been issued 3,275,200 shares of Common Stock, of which (i) 3,200,000 were received on April 1, 2022 as the Founder and (ii) 200 shares were received on August 5, 2022, in exchange for $200, as part of the Form C Offering and 75,000 were received on April 1, 2023 per his employment contract. Additionally, Hope A Stawski and Scott A. Stawski, through Ham and Cheese Events LLC, own jointly 125,000 shares of Common Stock issued by debt conversion on June 30, 2023.
/s/ Scott A. Stawski by Nelson Mullins Riley & Scarborough LLP with Power of Attorney 02/20/2024
** 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.