Sec Form 4 Filing - Moorby Tony @ Acacia Diversified Holdings, Inc. - 2012-02-28

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Moorby Tony
2. Issuer Name and Ticker or Trading Symbol
Acacia Diversified Holdings, Inc. [ *iw3zccd]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
_____ Officer (give title below) X __ Other (specify below)
None
(Last) (First) (Middle)
7873 EASTGATE BOULEVARD
3. Date of Earliest Transaction (MM/DD/YY)
02/28/2012
(Street)
MT. JULIET, TN37122
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common stock 02/28/2012 J( 1 ) 500,000 ( 2 ) D $ 0 0 D
Common stock 02/28/2012 J( 7 ) 1,000 ( 7 ) D $ 0 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Common stock purchase options $ 0.48 ( 5 ) 02/28/2012 J( 3 ) 65,000 11/08/2009( 4 ) 02/28/2012 Common stock 65,000 $ 0.48 ( 6 ) 0 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Moorby Tony
7873 EASTGATE BOULEVARD
MT. JULIET, TN37122
None
Signatures
/s/ Tony Moorby by /s/ Steven L. Sample, PoA 02/22/2013
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Shares returned to issuer pursuant to terms of Settlement Agreement and Release of even date herewith.
( 2 )Shares returned to issuer for cancellation and return to Issuer's treasury.
( 3 )Common stock purchase options returned to issuer pursuant to terms of Settlement Agreement and Release of even date herewith
( 4 )50,000 common stock purchase options were exercisable on January 1, 2009, at an exercise price of $0.50 per share,; and, 15,000 common stock purchase options were exercisable at $0.10 per share, all of which options are now cancelled by issuer.
( 5 )Average exercise price of the common stock purchase options
( 6 )Average price based on options at issue dates
( 7 )Shares returned to giftor pursuant to terms of Settlement Agreement and Release of even date herewith.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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