0001415889-23-009942.txt : 20230616 0001415889-23-009942.hdr.sgml : 20230616 20230616162427 ACCESSION NUMBER: 0001415889-23-009942 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230614 FILED AS OF DATE: 20230616 DATE AS OF CHANGE: 20230616 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SAMPSON RANDALL D CENTRAL INDEX KEY: 0001042527 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-31588 FILM NUMBER: 231021519 MAIL ADDRESS: STREET 1: 1100 CANTERBURY ROAD CITY: SHAKOPEE STATE: MN ZIP: 55379 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Pineapple Energy Inc. CENTRAL INDEX KEY: 0000022701 STANDARD INDUSTRIAL CLASSIFICATION: TELEPHONE & TELEGRAPH APPARATUS [3661] IRS NUMBER: 410957999 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 10900 RED CIRCLE DRIVE CITY: MINNETONKA STATE: MN ZIP: 55343 BUSINESS PHONE: 9529961674 MAIL ADDRESS: STREET 1: 10900 RED CIRCLE DRIVE CITY: MINNETONKA STATE: MN ZIP: 55343 FORMER COMPANY: FORMER CONFORMED NAME: Pineapple Holdings, Inc. DATE OF NAME CHANGE: 20220328 FORMER COMPANY: FORMER CONFORMED NAME: COMMUNICATIONS SYSTEMS INC DATE OF NAME CHANGE: 19950401 4 1 form4-06162023_080623.xml X0407 4 2023-06-14 0000022701 Pineapple Energy Inc. PEGY 0001042527 SAMPSON RANDALL D 10900 RED CIRCLE DRIVE MINNETONKA MN 55343 true false false false 0 Common Stock 2023-06-14 5 G 0 23773 0 A 58101 D Common Stock 170333 I See footnotes Held as of June 14, 2023 by the Sampson Family Real Estate Holdings, LLC (SFREH), of which Mr. Sampson is the sole manager. Members of SFREH include the Marian Arlis Sampson 2012 Family Revocable Trust, the Curtis A. Sampson Family Trust, and the Randall D. Sampson GST Trust, of which Mr. Sampson is the grantor and his grandchildren are beneficiaries. Mr. Sampson and his children are among the beneficiaries of the Marian Arlis Sampson 2012 Family Irrevocable Trust and the Curtis A. Sampson Family Trust. Mr. Sampson disclaims beneficial ownership in membership interests of SFREH in which he has no pecuniary interest. Following the death of Curtis A. Sampson on July 16, 2020, Randall D. Sampson became the executor of the estate of Curtis A. Sampson, became the trustee of certain trusts of Curtis A. Sampson that held Company stock and was granted other fiduciary powers relating to Company stock. Transactions by Mr. Sampson in Company stock in his fiduciary capacity subsequent to July 16, 2020 are exempt from reporting under Rule 16a-2(d)(1). /s/ Christine G. Long, Attorney-in-fact for Randall D. Sampson 2023-06-16