Sabas Carrillo - Dec 31, 2024 Form 5 Insider Report for BLUM HOLDINGS, INC. (BLMH)

Role
Chief Executive Officer, Director, 10%+ Owner
Signature
/s/ Sabas Carrillo
Stock symbol
BLMH
Transactions as of
Dec 31, 2024
Transactions value $
$6,164,914
Form type
5
Date filed
2/14/2025, 07:15 PM
Previous filing
Dec 18, 2024
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction BLMH Common Stock Other $6.16M +3.81M +338.96% $1.62 4.93M Dec 31, 2024 By Adnant, LLC F1, F2, F3
holding BLMH Common Stock 87.8K Dec 31, 2024 Direct

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction BLMH Series V Preferred Stock Other 0 0% 3.57M Dec 30, 2024 Common Stock 1.19M By Adnant, LLC F4, F5, F6
transaction BLMH Warrants to Purchase Common Stock Disposed to Issuer $0 -179K -100% $0.00 0 Dec 30, 2024 Common Stock 0 $2.80 By Adnant, LLC F7
transaction BLMH Warrants to Purchase Common Stock Award $0 +595K $0.00 595K Dec 30, 2024 Common Stock 595K $0.46 By Adnant, LLC F7
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Conversion of outstanding debt in the amount of $6,165,050 owed by the Company to Adnant, LLC into shares of common stock.
F2 Conversion price of $1.61874 per share.
F3 Reporting Person is the sole member of Adnant, LLC.
F4 Not applicable. See footnote 5.
F5 Reporting Person holds 3,571,429 shares of Series V Preferred Stock ("Series V Stock") and is reporting herein a change in the conversion ratio of such stock to common stock only. Effective December 30, 2024, Issuer amended the certificate of designation of its Series V Stock pursuant to which each share of Series V Stock (a) became convertible into 1/3 of a share of common stock, (b) will automatically be converted to common stock on the fourth anniversary of the date of issuance, and (c) prior to such anniversary, the holder is entitled to convert shares of Series V Stock upon written notice. Issuer and Reporting Person entered into an amendment to the Series V Stock purchase agreement in connection therewith.
F6 See footnote 5.
F7 These two warrants transactions involved an amendment of outstanding warrants to purchase common stock, resulting in the cancellation of the old warrant and the grant of a replacement warrant.