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*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 07/12/2017 | 3. Issuer Name and Ticker or Trading Symbol CEN BIOTECH INC [ CENBF ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) 04/22/2021 | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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 | 13,321(1) | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 | ||||
Convertible Note | 05/24/2016 | (3) | Common Stock | 62,500(2) | 1.6 | D | |
Convertible Note | 11/25/2016 | (3) | Common Stock | 125,000(2) | 1.6 | D | |
Convertible Note | 12/14/2016 | (3) | Common Stock | 156,250(2) | 1.6 | D | |
Convertible Note | 02/09/2017 | (3) | Common Stock | 312,500(2) | 1.6 | D |
Explanation of Responses: |
1. Harold Aubrey de Lavenu (the "Reporting Person") was appointed to his position with CEN Biotech, Inc. (the "Issuer") on July 12, 2017 and owned 13,321 shares of the Issuer's common stock on such date. On April 2, 2021, the Issuer appointed the Reporting Person to serve as a Vice President of the Issuer effective as of April 2, 2021 |
2. Additionally the Reporting Person owned convertible notes on July 12, 2017, which the Reporting Person purchased from the Issuer which were at such time and still are convertible into 656,250 shares of the Issuer's common stock. |
3. The convertible notes included in this table matured on May 12, 2018, November 25, 2018, December 14, 2018, and February 19, 2019, respectively, (the "Maturity Dates"), however, the ability to convert the notes into shares did not expire on the Maturity Dates of the notes. |
/s/ Harold Aubrey de Lavenu | 05/28/2021 | |
** 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. |