0001628280-23-041922.txt : 20231219 0001628280-23-041922.hdr.sgml : 20231219 20231219111521 ACCESSION NUMBER: 0001628280-23-041922 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231217 FILED AS OF DATE: 20231219 DATE AS OF CHANGE: 20231219 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cacioppo James CENTRAL INDEX KEY: 0001455939 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-56468 FILM NUMBER: 231496025 MAIL ADDRESS: STREET 1: 551 MADISON AVENUE STREET 2: 10TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Jushi Holdings Inc. CENTRAL INDEX KEY: 0001909747 STANDARD INDUSTRIAL CLASSIFICATION: MEDICINAL CHEMICALS & BOTANICAL PRODUCTS [2833] ORGANIZATION NAME: 03 Life Sciences 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_1703002512.xml FORM 4 X0508 4 2023-12-17 0 0001909747 Jushi Holdings Inc. JUSH/JUSHF 0001455939 Cacioppo James C/O JUSHI HOLDINGS INC. 301 YAMATO ROAD, SUITE 3250 BOCA RATON FL 33431 1 1 1 0 Chief Executive Officer 0 Stock Option (right to buy) 0.55 2023-12-17 4 A 0 3000000 0.55 A 2033-12-17 Subordinate Voting Shares 3000000 3000000 D Warrant (right to buy) 0.80 2023-12-17 4 A 0 718750 0.80 A 2026-12-07 Subordinate Voting Shares 718750 718750 D One-half of the Options will vest on January 1, 2024, and the second half will vest on January 1, 2025. Vested. /s/ James Cacioppo 2023-12-19