0001731122-23-001907.txt : 20231016 0001731122-23-001907.hdr.sgml : 20231016 20231016175423 ACCESSION NUMBER: 0001731122-23-001907 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220502 FILED AS OF DATE: 20231016 DATE AS OF CHANGE: 20231016 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dhalla Fatima CENTRAL INDEX KEY: 0001913908 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40471 FILM NUMBER: 231328140 MAIL ADDRESS: STREET 1: 1010 PALM AVE, #302 CITY: WEST HOLLYWOOD STATE: CA ZIP: 90069 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SPLASH BEVERAGE GROUP, INC. CENTRAL INDEX KEY: 0001553788 STANDARD INDUSTRIAL CLASSIFICATION: BEVERAGES [2080] IRS NUMBER: 341720075 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1314 E LAS OLAS BLVD, SUITE 221 CITY: FORT LAUDERDALE STATE: FL ZIP: 33301 BUSINESS PHONE: 954.745.5815 MAIL ADDRESS: STREET 1: 1314 E LAS OLAS BLVD, SUITE 221 CITY: FORT LAUDERDALE STATE: FL ZIP: 33301 FORMER COMPANY: FORMER CONFORMED NAME: Canfield Medical Supply, Inc. DATE OF NAME CHANGE: 20120709 4 1 ownership.xml X0508 4 2022-05-02 0 0001553788 SPLASH BEVERAGE GROUP, INC. SBEV 0001913908 Dhalla Fatima C/O SPLASH BEVERAGE GROUP, INC. 1314 E LAS OLAS BLVD, SUITE 221 FORT LAUDERDALE FL 33301 0 1 0 0 Interim CFO 0 Stock options 1.12 2022-05-02 4 A 0 35000 0.00 A 2032-05-02 Common stock 35000 35000 D The options were issued in connection with serving as the interim chief financial officer of SBEV, pursuant to the 2020 Long-Term Incentive Compensation Plan. All 35,000 options vested on May 2, 2022. /s/ Fatima Dhalla 2023-10-16