Sec Form 4 Filing - Milmoe William H. @ Celsius Holdings, Inc. - 2017-10-09

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
Milmoe William H.
2. Issuer Name and Ticker or Trading Symbol
Celsius Holdings, Inc. [ CELH]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
3299 N.W. 2ND AVENUE
3. Date of Earliest Transaction (MM/DD/YY)
10/09/2017
(Street)
BOCA RATON, FL33431
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
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
Series C Convertible Preferred Stock $ 0.52 10/09/2017 J( 1 ) 383 ( 2 ) 12/31/2018 Common Stock 736,538 $ 1,000 2,763 I CDS Ventures of South Florida, LLC ( 3 )
Reporting Owners
Reporting Owner Name / Address Relationships
Dir ector 10% Owner Officer Other
Milmoe William H.
3299 N.W. 2ND AVENUE
BOCA RATON, FL33431
X
Signatures
/s/ William H. Milmoe 10/11/2017
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Represents the issuance to CDS Ventures of South Florida, LLC, as the holder of shares of Series C Convertible Preferred Stock, of 383 additional shares of Series C Convertible Preferred Stock pursuant to the applicable preferred dividend that accrues on the stated value of such shares at a rate of 6% per annum.
( 2 )The holder of Series C Convertible Preferred Stock has the right to convert at any time until the applicable maturity date for such shares.
( 3 )William H. Milmoe is a Manager of CDS Ventures of South Florida, LLC which is the holder of record of the shares of Series C Convertible Preferred Stock listed above.

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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