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5//SEC Filing

Carrillo Sabas D 5

Accession 0001437749-25-004084

CIK 0001996210other

Filed

Feb 13, 7:00 PM ET

Accepted

Feb 14, 7:15 PM ET

Size

13.4 KB

Accession

0001437749-25-004084

Insider Transaction Report

Form 5
Period: 2024-12-31
Carrillo Sabas D
DirectorChief Executive Officer10% Owner
Transactions
  • Other

    Common Stock

    2024-12-31$1.62/sh+3,808,559$6,164,9144,932,154 total(indirect: By LLC)
  • Other

    Series V Preferred Stock

    2024-12-30+03,571,429 total(indirect: By LLC)
    Common Stock (1,190,476 underlying)
  • Disposition to Issuer

    Warrants to Purchase Common Stock

    2024-12-30178,5710 total(indirect: By LLC)
    Exercise: $2.80From: 2023-01-03Exp: 2025-12-31Common Stock (0 underlying)
  • Award

    Warrants to Purchase Common Stock

    2024-12-30+595,238595,238 total(indirect: By LLC)
    Exercise: $0.46From: 2024-12-30Exp: 2027-12-31Common Stock (595,238 underlying)
Holdings
  • Common Stock

    87,787
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.

Issuer

BLUM HOLDINGS, INC.

CIK 0001996210

Entity typeother

Related Parties

1
  • filerCIK 0001876882

Filing Metadata

Form type
5
Filed
Feb 13, 7:00 PM ET
Accepted
Feb 14, 7:15 PM ET
Size
13.4 KB