Sec Form 4 Filing - KRAUSS MARLENE @ 180 Life Sciences Corp. - 2020-10-06

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
KRAUSS MARLENE
2. Issuer Name and Ticker or Trading Symbol
180 Life Sciences Corp. [ ATNF]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
30 PARK PLACE, SUITE 64B
3. Date of Earliest Transaction (MM/DD/YY)
10/06/2020
(Street)
NEW YORK, NY10007
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ 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 10/06/2020 C 198,751 ( 1 ) A $ 4 2,687,816 I See footnote ( 3 )
Common Stock 10/06/2020 C 47,302 ( 2 ) A 2,489,065 I See footnote ( 3 )
Common Stock 10/06/2020 J 906,250 D 3,395,315 I See footnote ( 3 )
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
Warrants $ 11.5 11/06/2020 J( 4 ) 236,507 12/06/2020 11/06/2025 common stock 236,507 $ 0 236,507 I See footnote ( 3 )
Rights to acquire common stock ( 2 ) 11/06/2020 C( 2 ) 473,013 ( 2 ) ( 2 ) common stock 47,302 $ 0 0 I See footnote ( 3 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
KRAUSS MARLENE
30 PARK PLACE, SUITE 64B
NEW YORK, NY10007
X
KBL IV SPONSOR LLC
30 PARK PLACE, SUITE 64B
NEW YORK, NY10007
X
Signatures
/s/ Marlene Krauss, M.D. 11/10/2020
Signature of Reporting Person Date
/s/ Marlene Krauss, M.D., as Managing Member of KBL IV Sponsor LLC 11/10/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Represents shares of common stock that were issued to KBL IV Sponsor LLC ("KBL Sponsor") are a result of the automatic conversion of a promissory note in the principal amount of $795,003 that was previously issued by the issuer to KBL Sponsor, which note automatically converted into shares of the common stock of the issuer on November 6, 2020 upon the closing of the business combination transaction between the issuer and 180 Life Corp. (f/k/a 180 Life Science Corp.) (such business combination transaction, the "Merger")
( 2 )Reflects shares of common stock that were issued to KBL Sponsor as a result of the automatic conversion, upon the closing of the Merger, of 473,013 rights held by KBL Sponsor, with each right convertible into 1/10th of one share of common stock upon the closing of the Merger. The rights were included in units that were issued by the issuer in a private placement in June 2017 in connection with the issuer's initial public offering.
( 3 )The shares are held directly by KBL Sponsor. Dr. Marlene Krauss, the former Chief Executive Officer, and a former memeber of the Board of Directors, of the issuer, is the sole managing member of KBL Sponsor. Consequently, she may be deemed the beneficial owner of the shares of common stock held by KBL Sponsor, and she has sole voting and dispositive control over such securities. Dr. Krauss disclaims beneficial ownership over any securities owned by KBL Sponsor in which she does not have a pecuniary interest.
( 4 )The warrants were included in the units that were issued by the issuer in a private placement in June 2017 in connection with the issuer's initial public offering. The warrants are exercisable beginning 30 days following the closing of the Merger by their terms. The Sponsor was deemed to have acquired beneficial ownership of the shares underlying the warrant upon the consummation of the business combination on November 6, 2020, since the warrants became exercisable within 30 days.
( 5 )In connection with the closing of the Merger, the Sponsor transferred to Tyche Capital LLC an aggregate of 906,250 shares of common stock that the Sponsor originally acquired in September 2016, which shares were placed into an escrow account under that certain Escrow Agreement, dated April 10, 2019, by and among the Sponsor, the issuer, Tyche Capital LLC and Continental Stock Transfer & Trust Company. The parties entered into the Escrow Agreement in connection with the Business Combination Agreement relating to the Merger.

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