0001664787-16-000004.txt : 20160511 0001664787-16-000004.hdr.sgml : 20160511 20160511090021 ACCESSION NUMBER: 0001664787-16-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160509 FILED AS OF DATE: 20160511 DATE AS OF CHANGE: 20160511 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Acacia Diversified Holdings, Inc. CENTRAL INDEX KEY: 0001001463 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MOTOR VEHICLES & MOTOR VEHICLE PARTS & SUPPLIES [5010] IRS NUMBER: 752095676 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 13575 58TH STREET NORTH - #138 CITY: CLEARWATER STATE: FL ZIP: 33760 BUSINESS PHONE: 877-513-6294 MAIL ADDRESS: STREET 1: 13575 58TH STREET NORTH - #138 CITY: CLEARWATER STATE: FL ZIP: 33760 FORMER COMPANY: FORMER CONFORMED NAME: ACACIA AUTOMOTIVE INC DATE OF NAME CHANGE: 20070209 FORMER COMPANY: FORMER CONFORMED NAME: GIBBS CONSTRUCTION INC DATE OF NAME CHANGE: 19950927 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Roberts Gary Jack Jr CENTRAL INDEX KEY: 0001664919 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14088 FILM NUMBER: 161638200 MAIL ADDRESS: STREET 1: 1126 PIN OAK LANE CITY: BRENTWOOD STATE: TN ZIP: 37027 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2016-05-09 0 0001001463 Acacia Diversified Holdings, Inc. ACCA 0001664919 Roberts Gary Jack Jr 13575 58TH STREET NORTH - #138 CLEARWATER FL 33760 1 0 0 0 Common stock 2016-05-09 4 P 0 100000 0.5 A 202000 D Reporting Person acquired restricted Common shares of Issuer in private transactions of 20,000 shares on 5/9/2016 and 80,000 shares on 5/11/2016. Reporting Person acquired restricted Common shares of Issuer at $0.50 per share in private transactions of 20,000 shares on 5/9/2016 and 80,000 shares on 5/11/2016. Reporting Person disclaims any beneficial ownership in securities held by others, and disclaims beneficial ownership of any other person in his securities. /s/ Gary Jack Roberts, Jr. by Steven L. Sample, PoA 2016-05-11