0001062993-23-018531.txt : 20230927 0001062993-23-018531.hdr.sgml : 20230927 20230927170952 ACCESSION NUMBER: 0001062993-23-018531 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230926 FILED AS OF DATE: 20230927 DATE AS OF CHANGE: 20230927 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: 231285419 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 X0508 4 2023-09-26 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 0 Common Stock 2023-09-26 4 P 0 4926 1.15 A 24624 I By Spouse Common Stock 3227043 D Mr. Jacoby disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. /s/ Andrew P. Campbell as attorney-in-fact for Michael Z. Jacoby 2023-09-27