SEC Form 3: New insider Buckhout Laurie M claimed ownership of 16,290 shares (Amendment)
$CTM
Professional Services
Consumer Discretionary
| FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 10/12/2022 |
3. Issuer Name and Ticker or Trading Symbol
Castellum, Inc. [ CTM ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) 10/12/2022 |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Beneficially Owned | |||
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| 1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
| Common Stock, par value $0.0001 per share | 16,290(1) | D | |
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Convertible Promissory Note | (2) | (2) | Common Stock | (2) | 0.26 | I | See footnote(2) |
| Explanation of Responses: |
| 1. Adjusted for 1-for-20 reverse stock split. |
| 2. The Buckhout Charitable Remainder Trust, Laurie Buckhout, TTEE, is the holder of a convertible promissory note in the principal amount of $3,709,617 which has a maturity date of September 30, 2024 and is convertible into Common Stock at $0.26 per share. At the closing of the Company's offering it is expected that $1,000,000 of the principal amount then outstanding will be converted into 3,846,154 shares of Common Stock at $0.26 per share. |
| Remarks: |
| This amendment is being filed to correctly report (a) the Reporting Person as a 10% owner of the Issuer and (b) certain shares of Common Stock held by the Reporting Person at the time of the original filing. |
| /s/ Laurie Buckhout | 08/24/2023 | |
| ** Signature of Reporting Person | Date | |
| 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 5 (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. | ||