SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Lang Steven

(Last) (First) (Middle)
8530 WILSHIRE BLVD,
SUITE 450

(Street)
BEVERLY HILLS, CA 90211

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
BARFRESH FOOD GROUP INC. [ BRFH ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
12/19/2016
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/13/2017 J 138,596 A (1) 338,596 D
Common Stock 12/28/2017 P 17,623 A (2) 19,072,451 I Sidra Pty Ltd
Common Stock 12/28/2018 P 54,726 A (2) 19,127,177 I Sidra Pty Ltd
Common Stock 03/14/2020 J 60,000 A (3) 60,000 I Hodumo Pty Ltd
Common Stock 03/23/2020 J 319,365 A (4) 379,365 I Hodumo Pty Ltd
Common Stock 09/28/2020 J 136,871 A (5) 516,236 I Hodumo Pty Ltd
Common Stock 05/26/2021 J 53,815 A (3) 570,051 I Hodumo Pty Ltd
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
J Warrant $0.75 09/27/2016 09/27/2021 Common Stock 44,082 44,082 I Sidra Pty Ltd
Stock option $0.74 12/19/2016 A 166,667 12/19/2016 12/19/2024 Common Stock 166,667 (6) 166,667 D
Stock option $0.77 01/17/2017 A 40,323 01/17/2017 01/17/2025 Common Stock 40,323 (6) 40,323 D
Stock option $0.5 01/16/2018 A 64,744 01/16/2018 01/16/2026 Common Stock 64,744 (6) 64,744 D
Stock option $0.6 07/16/2018 A 59,023 07/16/2018 07/16/2026 Common Stock 59,023 (6) 59,023 D
L Warrant M2 $0.6 11/30/2018 A 80,645 11/30/2018 11/30/2021 Common Stock 80,645 (7) 80,645 I Hodumo Pty Ltd
Stock option $0.65 01/16/2019 A 53,711 01/16/2019 01/16/2027 Common Stock 53,711 (6) 53,711 D
Stock option $0.47 07/15/2019 A 71,769 07/15/2019 07/15/2027 Common Stock 71,769 (6) 71,769 D
O Warrants $0.6 03/23/2020 A 159,683 03/20/2020 03/20/2023 Common Stock 159,683 (4) 159,683 I Hodumo Pty Ltd
P Warrants $0.6 03/23/2020 A 180,000 03/20/2020 03/23/2023 Common Stock 180,000 (4) 180,000 I Hodumo Pty Ltd
O Warrants $0.6 09/28/2020 A 68,436 09/28/2020 09/28/2023 Common Stock 68,436 (5) 68,436 I Hodumo Pty Ltd
P Warrants $0.6 09/28/2020 A 77,143 09/28/2020 09/28/2023 Common Stock 77,143 (5) 77,143 I Hodumo Pty Ltd
Explanation of Responses:
1. Shares were issued as incentive compensation.
2. Shares were acquired through a cashless exercise of a warrant.
3. Shares were issued in lieu of interest on its M1 convertible note, valued according to the terms of the note at $0.60 per share.
4. On March 23, 2020, Hodumo received shares of common stock upon conversion of its convertible note and warrants for participation in the conversion.
5. On September 28, 2020, Hodumo received additional shares due to a price adjustment on the convertible note conversion, as well as additional warrants.
6. Stock option granted as non-employee director compensation.
7. Issued in connection with investment in note.
/s/ Steven Lang 07/06/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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