0001628280-23-039750.txt : 20231121 0001628280-23-039750.hdr.sgml : 20231121 20231121153606 ACCESSION NUMBER: 0001628280-23-039750 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231117 FILED AS OF DATE: 20231121 DATE AS OF CHANGE: 20231121 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOSIER MICHELLE O CENTRAL INDEX KEY: 0001182453 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-56468 FILM NUMBER: 231427647 MAIL ADDRESS: STREET 1: 207 WOOD ROAD STREET 2: TREDEGAR CORP CITY: 1100 BOULDERS PARKWAY STATE: VA ZIP: 23225 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Jushi Holdings Inc. CENTRAL INDEX KEY: 0001909747 STANDARD INDUSTRIAL CLASSIFICATION: MEDICINAL CHEMICALS & BOTANICAL PRODUCTS [2833] IRS NUMBER: 981547061 STATE OF INCORPORATION: A1 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 301 YAMATO ROAD STREET 2: SUITE 3250 CITY: BOCA RATON STATE: FL ZIP: 33431 BUSINESS PHONE: 5616179100 MAIL ADDRESS: STREET 1: 301 YAMATO ROAD STREET 2: SUITE 3250 CITY: BOCA RATON STATE: FL ZIP: 33431 4 1 wk-form4_1700598956.xml FORM 4 X0508 4 2023-11-17 0 0001909747 Jushi Holdings Inc. JUSH/JUSHF 0001182453 MOSIER MICHELLE O 301 YAMATO ROAD, SUITE 3250 BOCA RATON FL 33431 0 1 0 0 Chief Financial Officer 0 Warrant (right to buy) 1.75 2023-11-17 4 D 0 200000 D 2032-12-09 Subordinate Voting Shares 200000 200000 D This Warrant provided for vesting as to 20% of the total number of Shares subject to the Warrant on each yearly anniversary after the Vesting Commencement Date (11/2/2022), subject to continuous service. On November 17, 2023, the issuer canceled a Warrant for 200,000 shares of the issuer's Subordinate Voting Shares granted to the reporting person. In exchange, the reporting person will receive a replacement Warrant for 200,000 shares on or about December 17, 2023. /s/ Michelle O. Mosier 2023-11-21