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*
KRAUSS MARLENE

(Last) (First) (Middle)
527 STANTON CHRISTIANA RD.

(Street)
NEWARK DE 19713

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/01/2017
3. Issuer Name and Ticker or Trading Symbol
KBL MERGER CORP. IV [ KBLMU ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
06/01/2017
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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 Stock 2,875,000 I See Footnotes(1)(2)
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
1. Name and Address of Reporting Person*
KRAUSS MARLENE

(Last) (First) (Middle)
527 STANTON CHRISTIANA RD.

(Street)
NEWARK DE 19713

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
1. Name and Address of Reporting Person*
KBL IV SPONSOR LLC

(Last) (First) (Middle)
527 STANTON CHRISTIANA ROAD

(Street)
NEWARK DE 19713

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. These shares represent common stock held by KBL IV Sponsor LLC (the "Sponsor"), acquired pursuant to a subscription agreement by and between the Sponsor and the registrant. Marlene Krauss, the Chief Executive Officer of the registrant, is the managing member of the Sponsor. Dr. Krauss has sole voting and dispositive control over the shares held by the Sponsor and may be deemed the beneficial owner of such shares. These shares include an aggregate of 375,000 shares that are subject to forfeiture by the Sponsor to the extent that the underwriters do not exercise their overallotment option in connection with the registrant's initial public offering in full.
2. Dr. Krauss disclaims beneficial ownership over any securities owned by the Sponsor in which she does not have any pecuniary interest.
/s/ Marlene Krauss, M.D. 06/09/2017
/s/ Marlene Krauss, as Managing Member of KBL IV Sponsor LLC 06/09/2017
** 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.
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