0001209191-23-039128.txt : 20230622 0001209191-23-039128.hdr.sgml : 20230622 20230622170610 ACCESSION NUMBER: 0001209191-23-039128 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230620 FILED AS OF DATE: 20230622 DATE AS OF CHANGE: 20230622 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FORST EDWARD C CENTRAL INDEX KEY: 0001280491 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40125 FILM NUMBER: 231034109 MAIL ADDRESS: STREET 1: 85 BROAD STREET CITY: NEW YORK STATE: NY ZIP: 10004 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Local Bounti Corporation/DE CENTRAL INDEX KEY: 0001840780 STANDARD INDUSTRIAL CLASSIFICATION: AGRICULTURE PRODUCTION - CROPS [0100] IRS NUMBER: 981584830 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 W. MAIN ST. CITY: HAMILTON STATE: MT ZIP: 59840 BUSINESS PHONE: 406-361-3711 MAIL ADDRESS: STREET 1: 400 W. MAIN ST. CITY: HAMILTON STATE: MT ZIP: 59840 FORMER COMPANY: FORMER CONFORMED NAME: Leo Holdings III Corp. DATE OF NAME CHANGE: 20210115 4 1 doc4.xml FORM 4 SUBMISSION X0407 4 2023-06-20 0 0001840780 Local Bounti Corporation/DE LOCL 0001280491 FORST EDWARD C C/O LOCAL BOUNTI CORPORATION 400 W. MAIN ST. HAMILTON MT 59840 1 0 0 0 0 Common Stock 2023-06-20 4 A 0 21237 0.00 A 77406 D Common Stock 55911 I By Forst GST LLC Common Stock 36499 I By Wellfor LLC Warrants to purchase Common Stock 149.50 2021-12-19 2026-11-19 Common Stock 38076 495000 D Warrants to purchase Common Stock 149.50 2021-12-19 2026-11-19 Common Stock 39304 510952 I By Forst GST LLC Warrants to purchase Common Stock 149.50 2021-12-03 2026-11-19 Common Stock 1685 21912 D The restricted stock units will vest on the earlier of (1) the day before Local Bounti Corporation's (the "Issuer") next annual stockholders' meeting or (2) June 20, 2024, subject to the Reporting Person's continued service. Effective on June 15, 2023, the Issuer effected a 1 to 13 reverse stock split of its common stock (the "Reverse Stock Split"). The amount of securities reported on this Form 4 has been adjusted to reflect the Reverse Stock Split. The exercise price and amount of common stock underlying the warrants after exercise take into account the Reverse Stock Split. /s/ Kathleen Valiasek, as Attorney-in-Fact for Edward C. Forst 2023-06-22