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) 09/20/2017 | 3. Issuer Name and Ticker or Trading Symbol CANNASYS INC [ MJTK ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
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) |
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 | ||||
Series A Preferred Stock | (1) | (1) | Common Stock | 2,000,000 | 0 | D | |
Series B Preferred Stock | (2) | (2) | Common Stock | 2,000,000 | 0 | I | held by Beta Killers LLC(3) |
Explanation of Responses: |
1. Reporting person owns 500,000 shares of Series A Preferred Stock. At any time after six months from the time the issuer files an amendment to its articles of incorporation with the Nevada Secretary of State to effect an increase in its authorized shares of common stock (the "Recapitalization") and before the second anniversary of the Recapitalization, each share of Series A Preferred Stock may be converted at the holder's election into four shares of common stock. Mandatory conversion at second anniversary of the Recapitalization. |
2. Reporting person owns 2,000,000 shares of Series B Preferred Stock. At any time after six months from the Recapitalization and before the second anniversary of the Recapitalization, each share of Series B Preferred Stock may be converted at the holder's election into one share of common stock. Mandatory conversion at second anniversary of the Recapitalization. |
3. Reporting person is the managing member of Beta Killers LLC. |
Benjamin Tyson | 09/21/2017 | |
** 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. |