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