Sec Form 4/A Filing - Siokas Grigorios @ Cosmos Holdings Inc. - 2022-11-28-05:00

Insider filing report for Changes in Beneficial Ownership
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FORM 4/A
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
Siokas Grigorios
2. Issuer Name and Ticker or Trading Symbol
Cosmos Holdings Inc. [ COSM]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director X __ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Executive Officer
(Last) (First) (Middle)
5 AG. GEORGIOU STR., PILEA
3. Date of Earliest Transaction (MM/DD/YY)
11/28-05:00/2022
(Street)
THESSALONIKI, J3TK57001
4. If Amendment, Date Original Filed (MM/DD/YY)
11/28-05:00/2022
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, $.001 par value 11/28-05:00/2022 11/28-05:00/2022 P 801,261( 1 ) A $ 0.6215 20,135,429 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
Series A Preferred Stock $ 0.6215 11/28-05:00/2022 11/28-05:00/2022 C 498( 2 ) 02/28-05:00/2022 ( 3 ) Common Stock 1,612,177( 4 ) $ 0.6215 1,002 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Siokas Grigorios
5 AG. GEORGIOU STR., PILEA
THESSALONIKI, J3TK57001
X X Chief Executive Officer
Signatures
/s/ Grigorios Siokas 11/29-05:00/2022
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Mr. Siokas acquired these shares upon conversion of 498 shares of Series A Convertible Preferred Stock ("Series A Shares"), $1,000.00 stated value per share, convertible at $0.62152 per share.
( 2 )Mr. Siokas converted the Series A Shares, as set forth in Note (1), above pursuant to a Conversion Notice dated November 28, 2022.
( 3 )N/A
( 4 )Each Series A Share with a stated value of $1,000.00 per share is convertible at $0.62152 per share.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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