0001062993-21-012025.txt : 20211202 0001062993-21-012025.hdr.sgml : 20211202 20211202171914 ACCESSION NUMBER: 0001062993-21-012025 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211201 FILED AS OF DATE: 20211202 DATE AS OF CHANGE: 20211202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jacoby Michael Z CENTRAL INDEX KEY: 0001794504 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09043 FILM NUMBER: 211467809 BUSINESS ADDRESS: BUSINESS PHONE: 3018281200 MAIL ADDRESS: STREET 1: 7250 WOODMONT AVENUE STREET 2: SUITE 350 CITY: BETHESDA STATE: MD ZIP: 20814 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Broad Street Realty, Inc. CENTRAL INDEX KEY: 0000764897 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE [6500] IRS NUMBER: 363361229 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7250 WOODMONT AVE STREET 2: SUITE 350 CITY: BETHESDA STATE: MD ZIP: 20814 BUSINESS PHONE: 561-617-8050 MAIL ADDRESS: STREET 1: 7250 WOODMONT AVE STREET 2: SUITE 350 CITY: BETHESDA STATE: MD ZIP: 20814 FORMER COMPANY: FORMER CONFORMED NAME: MedAmerica Properties Inc. DATE OF NAME CHANGE: 20170619 FORMER COMPANY: FORMER CONFORMED NAME: Banyan Rail Services Inc. DATE OF NAME CHANGE: 20100106 FORMER COMPANY: FORMER CONFORMED NAME: BHIT INC DATE OF NAME CHANGE: 19990518 4 1 form4.xml STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES X0306 4 2021-12-01 0000764897 Broad Street Realty, Inc. BRST 0001794504 Jacoby Michael Z C/O BROAD STREET REALTY, INC. 7250 WOODMONT AVE, SUITE 350 BETHESDA MD 20814 1 1 0 0 Chief Executive Officer Common Stock 2021-12-01 4 P 0 1900 2.41 A 2622245 D /s/ Andrew P. Campbell as attorney-in-fact for Michael Z. Jacoby 2021-12-02