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

Reporting relationship: Chief Executive Officer, Director, 10%+ Owner
Issuer ticker: BLMH
Reported as of: 31 Dec 2024
Net transaction value: +$6,164,914
SEC form: 5
Accepted by SEC: 14 Feb 2025, 19:15:26 UTC
Prior SEC filing: 18 Dec 2024
Next SEC filing: 21 May 2025
Source filing: View source filing
Reporting owner signature: /s/ Sabas Carrillo

Key filing fact

Sabas D. Carrillo filed Form 5 for BLUM HOLDINGS, INC. (BLMH) on 14 Feb 2025.

Key facts

This page summarizes Sabas D. Carrillo's Form 5 filing for BLUM HOLDINGS, INC. (BLMH).
4 reported transactions and 3 derivative rows are listed below.
Accepted by SEC: 14 Feb 2025, 19:15.

Change

Previous filing in this sequence was filed on 18 Dec 2024.
Current net transaction value: +$6,164,914.

Research use

This tells you what this filing adds before you inspect full transaction and derivative tables.
You can trace every row back to the original SEC filing document.

Evidence

Official SEC source

Ownership activity is grounded in SEC Form 5 disclosures.

View source filing

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

BLMH transaction

Common Stock

Other

Transaction value: $6,164,914
Shares: +3,808,559
Change %: +339%
Price: $1.62
Shares after: 4,932,154
Date: 31 Dec 2024
Ownership: By Adnant, LLC
Footnotes: F1, F2, F3

BLMH holding

Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after: 87,787
Date: 31 Dec 2024
Ownership: Direct

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

BLMH transaction Derivative

Series V Preferred Stock

Other

Transaction value
Shares: 0
Change %: 0%
Price
Shares after: 3,571,429
Date: 30 Dec 2024
Ownership: By Adnant, LLC
Underlying class: Common Stock
Underlying amount: 1,190,476
Exercise price
Footnotes: F4, F5, F6

BLMH transaction Derivative

Warrants to Purchase Common Stock

Disposed to Issuer

Transaction value: $0
Shares: -178,571
Change %: -100%
Price: $0.000000
Shares after: 0
Date: 30 Dec 2024
Ownership: By Adnant, LLC
Underlying class: Common Stock
Underlying amount: 0
Exercise price: $2.80
Footnotes: F7

BLMH transaction Derivative

Warrants to Purchase Common Stock

Award

Transaction value: $0
Shares: +595,238
Change %
Price: $0.000000
Shares after: 595,238
Date: 30 Dec 2024
Ownership: By Adnant, LLC
Underlying class: Common Stock
Underlying amount: 595,238
Exercise price: $0.4600
Footnotes: F7

^* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 7 footnotes

Footnote F1

Conversion of outstanding debt in the amount of $6,165,050 owed by the Company to Adnant, LLC into shares of common stock.

Footnote F2

Conversion price of $1.61874 per share.

Footnote F3

Reporting Person is the sole member of Adnant, LLC.

Footnote F4

Not applicable. See footnote 5.

Footnote 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.

Footnote F6

See footnote 5.

Footnote 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.