Carrillo Sabas D 5
5 · BLUM HOLDINGS, INC. · Filed Feb 14, 2025
Insider Transaction Report
Form 5
Carrillo Sabas D
DirectorChief Executive Officer10% Owner
Transactions
- Other
Common Stock
2024-12-31$1.62/sh+3,808,559$6,164,914→ 4,932,154 total(indirect: By LLC) - Other
Series V Preferred Stock
2024-12-30+0→ 3,571,429 total(indirect: By LLC)→ Common Stock (1,190,476 underlying) - Disposition to Issuer
Warrants to Purchase Common Stock
2024-12-30−178,571→ 0 total(indirect: By LLC)Exercise: $2.80From: 2023-01-03Exp: 2025-12-31→ Common Stock (0 underlying) - Award
Warrants to Purchase Common Stock
2024-12-30+595,238→ 595,238 total(indirect: By LLC)Exercise: $0.46From: 2024-12-30Exp: 2027-12-31→ Common Stock (595,238 underlying)
Holdings
- 87,787
Common Stock
Footnotes (7)
- [F1]Conversion of outstanding debt in the amount of $6,165,050 owed by the Company to Adnant, LLC into shares of common stock.
- [F2]Conversion price of $1.61874 per share.
- [F3]Reporting Person is the sole member of Adnant, LLC.
- [F4]Not applicable. See footnote 5.
- [F5]Reporting Person holds 3,571,429 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.
- [F6]See footnote 5.
- [F7]These two warrants transactions involved an amendment of outstanding warrants to purchase common stock, resulting in the cancellation of the old warrant and the grant of a replacement warrant.