Sec Form 3 Filing - Nickoll Benjamin Edward @ Lowell Farms Inc. - 2021-08-30

Insider filing report for Changes in Beneficial Ownership
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FORM 3
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
Nickoll Benjamin Edward
2. Issuer Name and Ticker or Trading Symbol
Lowell Farms Inc. [ LOWLF]
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)
8 NORTH SHORE RD. UNIT B
3. Date of Earliest Transaction (MM/DD/YY)
08/30/2021
(Street)
WARREN, CT06777
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
Subordinate Voting Shares 600,000( 1 ) I See Footnote( 1 )
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 (rights to buy) $ 1.4 08/30/2021 08/30/2024 Subordinate Voting Shares( 2 )( 3 ) 300,000( 4 ) I See Footnote( 4 )
2022 Convertible Debenture of Indus Holding Company $ 0.23 08/17/2022 10/13/2023 Subordinate Voting Shares( 2 )( 3 ) 2,623,588( 5 ) I See Footnote( 5 )
Warrants (rights to buy) $ 0.26 08/17/2022 10/13/2023 Subordinate Voting Shares( 2 )( 3 ) 2,623,588( 6 ) I See Footnote( 6 )
2020 Convertible Debenture of Indus Holding Company $ 0.2 04/13/2020 10/13/2023 Subordinate Voting Shares( 2 )( 3 ) 6,226,505( 7 ) I See Footnote( 7 )
Warrants (rights to buy) $ 0.28 04/13/2020 10/13/2023 Subordinate Voting Shares( 2 )( 3 ) 6,226,505( 8 ) I See Footnote( 8 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Nickoll Benjamin Edward
8 NORTH SHORE RD. UNIT B
WARREN, CT06777
X
Signatures
/s/ Benjamin Nickoll 12/07/2022
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The Subordinate Voting Shares hold shared voting and dispositive power with John F. Nickoll Marital Trust owning 200,000 shares, Kestrel Foundation owning 200,000 shares, and Christine Armstrong owning 200,000 shares.
( 2 )The principal amount of each Convertible Debenture is convertible into Class C Common Shares of Indus Holding Company ("Class C Common Shares") at $0.20 per share. Class C Common Shares may be redeemed at the option of the holder for Subordinate Voting Shares of the issuer on a one-for-one basis in accordance with the certificate of incorporation of Indus Holding Company. Class C Common Shares may be redeemed at any time and have no expiration date.
( 3 )Interest accrues on the Convertible Debentures and is payable quarterly in arrears; any accrued and unpaid interest at the time of conversion of a Convertible Debenture is convertible into additional Class C Common Shares at $0.20 per share. Accrued interest is not included in the underlying share numbers.
( 4 )The $18,000,000 Offering Warrants hold shared voting and dispositive power with John F. Nickoll Marital Trust owning 100,000 shares, Kestrel Foundation owning 100,000 shares, and Christine Armstrong owning 100,000 shares.
( 5 )The Shares underlying the 2022 Convertible Debentures hold shared voting and dispositive power with John F. Nickoll Marital Trust owning 1,513,186 shares, Kestrel Foundation owning 648,508 shares, and Benjamin Nickoll Trust UWO Ann Nickoll owning 461,894 shares.
( 6 )The Warrants underlying the 2022 Convertible Debentures hold shared voting and dispositive power with John F. Nickoll Marital Trust owning 1,513,186 shares, Kestrel Foundation owning 648,508 shares, and Benjamin Nickoll Trust UWO Ann Nickoll owning 461,894 shares.
( 7 )The Shares underlying the 2020 Convertible Debentures hold shared voting and dispositive power with John F. Nickoll Marital Trust owning 3,524,435 shares, Kestrel Foundation owning 1,997,180 shares, and Benjamin Nickoll Trust UWO Ann Nickoll owning 704,890 shares.
( 8 )The Warrants underlying the 2020 Convertible Debentures hold shared voting and dispositive power with John F. Nickoll Marital Trust owning 3,524,435 shares, Kestrel Foundation owning 1,997,180 shares, and Benjamin Nickoll Trust UWO Ann Nickoll owning 704,890 shares.

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