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    SEC Form 3 filed by new insider Anderson Jill Ellen

    9/5/23 5:32:41 PM ET
    $SGBX
    RETAIL: Building Materials
    Consumer Discretionary
    Get the next $SGBX alert in real time by email
    SEC FORM 3 SEC Form 3
    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
    OMB APPROVAL
    OMB Number: 3235-0104
    Estimated average burden
    hours per response: 0.5
    1. Name and Address of Reporting Person*
    Anderson Jill Ellen

    (Last) (First) (Middle)
    C/O SAFE & GREEN HOLDINGS CORP.,
    990 BISCAYNE BLVD., #501, OFFICE 12

    (Street)
    MIAMI FL 33132

    (City) (State) (Zip)
    2. Date of Event Requiring Statement (Month/Day/Year)
    08/30/2023
    3. Issuer Name and Ticker or Trading Symbol
    SAFE & GREEN HOLDINGS CORP. [ SGBX ]
    4. Relationship of Reporting Person(s) to Issuer
    (Check all applicable)
    X Director 10% Owner
    Officer (give title below) Other (specify below)
    5. If Amendment, Date of Original Filed (Month/Day/Year)
    6. Individual or Joint/Group Filing (Check Applicable Line)
    X Form filed by One Reporting Person
    Form filed by More than One Reporting Person
    Table I - Non-Derivative Securities Beneficially Owned
    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)
    Table II - Derivative Securities Beneficially Owned
    (e.g., puts, calls, warrants, options, convertible securities)
    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
    Explanation of Responses:
    No securities are beneficially owned.
    /s/ Jill Ellen Anderson 09/05/2023
    ** 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.
    Get the next $SGBX alert in real time by email

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