Lucy Scientific Discovery (LSDIF) Form 3 Lucy Scientific Discovery / Livio Susin ownership change

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^*

Susin Livio

(Last) (First) (Middle)

C/O LUCY SCIENTIFIC DISCOVERY INC.

301-1321 BLANSHARD STREET

(Street)

VICTORIA A1 V8W 0B6

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
02/08/2023

3. Issuer Name and Ticker or Trading Symbol
Lucy Scientific Discovery, Inc. [ LSDI ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
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 Shares	125,500	D

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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
Stock Option (right to buy)	12/28/2020	12/27/2025	Common Shares	25,000	1.73(1)	D
Convertible Note	(2)	(2)	Common Shares	$21,965(3)	(2)	D

Explanation of Responses:

1. Conversion price was converted from Canadian dollars to US dollars based on the noon rate of US$1.00 = CAD$1.2806 on December 28, 2020.

2. Pursuant to a debt settlement agreement between the issuer and the reporting person, the note is convertible into common shares automatically upon the closing of the issuer's initial public offering at a 40% discount to the initial offering price.

3. Represents the principal amount of the convertible note and excludes interest that may accrue. Interest on the convertible note is payable annually, in cash or common shares, at the holder's discretion.

Remarks:

Exhibit List - Exhibit 24 - Power of Attorney

	/s/ Brian Zasitko, Attorney-in-Fact	02/09/2023
	** 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).
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