| 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) 12/31/2021 | 3. Issuer Name and Ticker or Trading Symbol Greenrose Holding Co Inc. [ GNRS ] | |||||||||||||
| 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) |
| Common Stock | 4,430,378(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 Promissory Note | 12/31/2021 | 12/31/2024 | Common Stock | 2,300,000(2) | 10 | D | |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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| Explanation of Responses: |
| 1. Represents shares held by True Harvest, LLC ("True Harvest"). Michael Macchiaroli is the sole manager of True Harvest and disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. |
| 2. Represents shares (the "Convertible Note Shares") issuable upon conversion of a convertible promissory note (the "Convertible Note") in the aggregate principal amount of $23 million held by True Harvest. The Convertible Note bears interest at a rate of 8.0% per annum and matures on December 31, 2024. All amounts of principal and interest under the Convertible Note may be paid in shares of common stock of The Greenrose Holding Company Inc. at a conversion price equal to $10.00, subject to adjustment, or, at True Harvest's election, in cash. The number of Convertible Note Shares reported in this Column 3 excludes shares issuable at the election of True Harvest upon conversion of accrued interest under the Convertible Note. Michael Macchiaroli is the sole manager of True Harvest and disclaims beneficial ownership of the Convertible Note Shares except to the extent of his pecuniary interest therein. |
| /s/ Michael Macchiaroli, Manager of True Harvest, LLC | 01/11/2022 | |
| /s/ Michael Macchiaroli | 01/11/2022 | |
| ** 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. | ||
