Sec Form 4 Filing - Mountain Crest Global Holdings LLC @ Mountain Crest Acquisition Corp. V - 2023-09-18

Insider filing report for Changes in Beneficial Ownership
"Insiders might sell their shares for any number of reasons, but they buy them for only one: they think the price will rise"
- Peter Lynch
What is insider trading>>
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
OMB APPROVAL
OMB Number: 3235-0287
Expires: November 30, 2011
Estimated average burden hours per response... 0.5
1. Name and Address of Reporting Person
Mountain Crest Global Holdings LLC
2. Issuer Name and Ticker or Trading Symbol
Mountain Crest Acquisition Corp. V [ MCAG]
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)
311 WEST 43RD STREET, 12TH FLOOR
3. Date of Earliest Transaction (MM/DD/YY)
09/18/2023
(Street)
NEW YORK, NY10036
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 09/18/2023 J( 1 ) 75,000 A ( 1 ) 2,015,800 D ( 2 )
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
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Mountain Crest Global Holdings LLC
311 WEST 43RD STREET, 12TH FLOOR
NEW YORK, NY10036
X
Liu Dong
311 WEST 43RD STREET, 12TH FLOOR
NEW YORK, NY10036
X
Signatures
By: /s/ Dong Liu Name: Dong Liu Title: Manager 09/20/2023
Signature of Reporting Person Date
By: /s/ Dong Liu 09/20/2023
Signature of Reporting Person Date
Explanation of Responses:
( 1 )On February 15, 2023, Mountain Crest Acquisition Corp. V (the "Company") issued a non-interest bearing, unsecured promissory note in the aggregate principal amount of $300,000 (the "Note") to the Reporting Person. On September 13, 2023, as approved by the Company's audit committee, the Company entered into a note conversion agreement (the "Note Conversion Agreement") with the Reporting Person, to convert the principal amount of the Note into 75,000 shares of the Company's Common Stock at $4:00 per share. On September 18, 2023, the Company issued 75,000 shares to the Reporting Person in satisfaction of the Note.
( 2 )The Shares are owned by Mountain Crest Global Holdings LLC, and Dong Liu, the sole manager of Mountain Crest Global Holdings LLC, has sole voting and dispositive power over the shares owned by Mountain Crest Global Holdings LLC.

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).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.