Sec Form 4 Filing - Bradford Zachary @ CLEANSPARK, INC. - 2021-11-08

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
Bradford Zachary
2. Issuer Name and Ticker or Trading Symbol
CLEANSPARK, INC. [ CLSK]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
CEO and President
(Last) (First) (Middle)
1185 SOUTH 1800 WEST, SUITE 3
3. Date of Earliest Transaction (MM/DD/YY)
11/08/2021
(Street)
WOODS CROSS, UT84087
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 11/08/2021 A 30,000( 1 ) A $ 0 131,973 D
Common Stock 11/08/2021 A 69,000( 2 ) A $ 0 382,973 D
Common Stock 323,864( 3 ) I By ZRB Holdings Inc.
Common Stock 12,000( 4 ) I By BlueChip Advisors 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
Employee Stock Option (Right to Buy) $ 20.48 11/08/2021 A 30,000 ( 5 ) 11/07/2024 Common Stock 30,000 $ 0 30,000 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Bradford Zachary
1185 SOUTH 1800 WEST
SUITE 3
WOODS CROSS, UT84087
X CEO and President
Signatures
/s/ Zachary Bradford 11/10/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Represents 30,000 restricted stock units awarded to the Reporting Person under the Issuer's 2017 Equity Incentive Plan, as amended (the "Plan"), in connection with the Reporting Person's service as an executive officer and director of the Issuer, which restricted stock units shall vest as follows: (i) 2,500 are vested upon issuance, and (ii) the remaining 27,500 shall vest in equal monthly installments over the next 11 months.
( 2 )Represents 69,000 shares of restricted common stock, the vesting of which shares is subject to the achievement of certain corporate milestones of the Issuer.
( 3 )The reporting person is the sole shareholder of ZRB Holdings Inc.
( 4 )The reporting person is a member of the limited liability company, BlueChip Advisors LLC, that directly owns the reported securities. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.
( 5 )Vesting of the options is subject to the achievement of certain corporate milestones of the Issuer.

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).

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