0001213900-21-064763.txt : 20211210 0001213900-21-064763.hdr.sgml : 20211210 20211210180431 ACCESSION NUMBER: 0001213900-21-064763 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211210 FILED AS OF DATE: 20211210 DATE AS OF CHANGE: 20211210 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Vu Quan Anh CENTRAL INDEX KEY: 0001892297 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38105 FILM NUMBER: 211486479 MAIL ADDRESS: STREET 1: 22616 ERWIN STREET CITY: WOODLAND HILLS STATE: CA ZIP: 91367 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: 180 Life Sciences Corp. CENTRAL INDEX KEY: 0001690080 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 813832378 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 830 MENLO AVENUE, SUITE 100 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-507-0669 MAIL ADDRESS: STREET 1: 830 MENLO AVENUE, SUITE 100 CITY: MENLO PARK STATE: CA ZIP: 94025 FORMER COMPANY: FORMER CONFORMED NAME: KBL MERGER CORP. IV DATE OF NAME CHANGE: 20161115 4 1 ownership.xml X0306 4 2021-12-10 0 0001690080 180 Life Sciences Corp. ATNF 0001892297 Vu Quan Anh 3000 EL CAMINO REAL, BLDG. 4 SUITE 200 PALO ALTO CA 94306 0 1 0 0 COO / Chief Business Officer Common Stock 2021-12-10 4 P 0 4500 3.90 A 12500 D /s/ Quan Anh Vu 2021-12-10