|5Feb 14, 7:06 PM ET

Chan Patty 5

5 · BLUM HOLDINGS, INC. · Filed Feb 14, 2025

Insider Transaction Report

Form 5
Period: 2024-12-31
Chan Patty
Chief Financial Officer
Transactions
  • Other

    Series V Preferred Stock

    2024-12-30+0714,286 total
    Common Stock (238,095 underlying)
  • Disposition to Issuer

    Warrants to Purchase Common Stock

    2024-12-3035,7140 total
    Exercise: $2.80From: 2023-01-03Exp: 2025-12-31Common Stock (0 underlying)
  • Award

    Warrants to Purchase Common Stock

    2024-12-30+119,048119,048 total
    Exercise: $0.46From: 2024-12-30Exp: 2027-12-31Common Stock (119,048 underlying)
Footnotes (4)
  • [F1]Not applicable. See footnote 2.
  • [F2]Reporting Person holds 714,286 shares of Series V Preferred Stock ("Series V Stock") and is reporting herein a change in the conversion ratio of such stock to common stock only. Effective December 30, 2024, Issuer amended the certificate of designation of its Series V Stock pursuant to which each share of Series V Stock (a) became convertible into 1/3 of a share of common stock, (b) will automatically be converted to common stock on the fourth anniversary of the date of issuance, and (c) prior to such anniversary, the holder is entitled to convert shares of Series V Stock upon written notice. Issuer and Reporting Person entered into an amendment to the Series V Stock purchase agreement in connection therewith.
  • [F3]See footnote 2.
  • [F4]These two warrants transactions involved an amendment of outstanding warrants to purchase common stoc), resulting in the cancellation of the old warrant and the grant of a replacement warrant.

Documents

1 file
  • 5
    rdgdoc.xmlPrimary

    FORM 5_CHAN 02-14-2025