0001628280-23-041920.txt : 20231219 0001628280-23-041920.hdr.sgml : 20231219 20231219111110 ACCESSION NUMBER: 0001628280-23-041920 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: Barack Louis Jon CENTRAL INDEX KEY: 0001939867 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-56468 FILM NUMBER: 231495981 MAIL ADDRESS: STREET 1: 301 YAMATO ROAD, SUITE 3250 CITY: BOCA RATON STATE: FL ZIP: 33431 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_1703002261.xml FORM 4 X0508 4 2023-12-17 0 0001909747 Jushi Holdings Inc. JUSH/JUSHF 0001939867 Barack Louis Jon C/O JUSHI HOLDINGS INC. 301 YAMATO ROAD, SUITE 3250 BOCA RATON FL 33431 0 1 0 0 President 0 Stock Option (right to buy) 0.55 2023-12-17 4 A 0 1000000 0.55 A 2033-12-17 Subordinate Voting Shares 1000000 1000000 D 1/3 of the Options will vest on 12/17/2024, 1/3 will vest on 12/17/2025, and 1/3 will vest on 12/17/2026, subject to continuous service. Does not include options and warrants to purchase an aggregate of 3,893,000 Subordinated Voting Shares of different classes held directly by such reporting person. For future filings, the reporting person intends to report in column 9 of Table II only the shares beneficially held of the same class for any reported transaction pursuant to SEC guidance. /s/ Louis Jon Barack 2023-12-19