Sec Form 4 Filing - Friedland Jeffrey @ Intiva BioPharma Inc. - 2017-11-29

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
Friedland Jeffrey
2. Issuer Name and Ticker or Trading Symbol
Intiva BioPharma Inc. [ KDRH]
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)
3773 CHERRY CREEK N. DRIVE, SUITE 575
3. Date of Earliest Transaction (MM/DD/YY)
11/29/2017
(Street)
DENVER, CO80209
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 11/29/2017 J 15,099,083 ( 1 ) A 24,000,000 ( 1 ) I By Intiva USA Inc.
Common Stock 11/29/2017 J 1,258,257 ( 1 ) A 2,000,000 ( 1 ) D
Common Stock 11/29/2017 J 130,859 ( 1 ) A 208,000 ( 1 ) I By Lane 6552 LLC
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
Class A Warrants (right to buy) $ 0.25 11/29/2017 J 20,800 11/29/2017 01/31/2018 Common Stock 20,800 ( 5 ) 20,800 I By Lane 9552 LLC
Class B Warrants (right to buy) $ 0.375 11/29/2017 J 20,800 11/29/2017 05/07/2018 Common Stock 20,800 ( 6 ) 20,800 I By Lane 6552 LLC
Class C Warrants (right to buy) $ 0.5 11/29/2017 J 20,800 11/29/2017 07/14/2018 Common Stock 20,800 ( 7 ) 20,800 I By Lane 6552 LLC
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Friedland Jeffrey
3773 CHERRY CREEK N. DRIVE, SUITE 575
DENVER, CO80209
X X Chief Executive Officer
Signatures
Jeffrey Friedland 11/30/2017
Signature of Reporting Person Date
Explanation of Responses:
( 1 )As adjusted to reflect a one-for-six reverse split of the issuer's common stock effective November 29, 2017
( 2 )Acquired in exchange for all of Intiva USA's shares of Intiva BioPharma Inc.
( 3 )Acquired in exchange for all of Jeffrey Friedland's shares of Intiva BioPharma Inc.
( 4 )Acquired in exchange for all of Lane 6552 LLC's shares of Intiva BioPharma Inc.
( 5 )Acquired in exchange for all of Lane 6552 LLC's Class A warrants of Intiva BioPharma Inc.
( 6 )Acquired in exchange for all of Lane 6552 LLC's Class B warrants of Intiva BioPharma Inc.
( 7 )Acquired in exchange for all of Lane 6552 LLC's Class C warrants of Intiva BioPharma Inc.

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).
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