Small Company Offering and Sale of Securities Without Registration (d)
01 Septiembre 2021 - 5:04AM
Edgar (US Regulatory)
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NoneEntity Type | 0001690080 | KBL Merger Corp. IV KBL MERGER CORP. IV |
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Corporation
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Limited Partnership
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Limited Liability Company
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General Partnership
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Business Trust
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Other |
| Name of Issuer |
180 Life Sciences Corp. |
| Jurisdiction of Incorporation/Organization |
| DELAWARE |
| |
| Year of Incorporation/Organization |
| |
o
| Over Five Years Ago |
| |
x
| Within Last Five Years (Specify Year) | 2016 |
| |
o
| Yet to Be Formed | |
| 2. Principal Place of Business and Contact Information |
| Name of Issuer | |
| 180 Life Sciences Corp. | |
| Street Address 1 | Street Address 2 |
| 3000 EL CAMINO REAL | BLDG. 4, SUITE 200 |
| City | State/Province/Country | ZIP/Postal Code | Phone No. of Issuer |
| PALO ALTO | CALIFORNIA | 94306 | 650-507-0669 |
| Last Name | First Name | Middle Name |
| Woody | James | N. |
| Street Address 1 | Street Address 2 |
| c/o 180 Life Sciences Corp. | 3000 El Camino Real, Bldg. 4, Suite 200 |
| City | State/Province/Country | ZIP/Postal Code |
| Palo Alto | CALIFORNIA | 94306 |
| Relationship: |
x
| Executive Officer |
x
| Director |
o
| Promoter |
| Clarification of Response (if Necessary) |
| | |
| Last Name | First Name | Middle Name |
| Pamir | Ozan | |
| Street Address 1 | Street Address 2 |
| c/o 180 Life Sciences Corp. | 3000 El Camino Real, Bldg. 4, Suite 200 |
| City | State/Province/Country | ZIP/Postal Code |
| Palo Alto | CALIFORNIA | 94306 |
| Relationship: |
x
| Executive Officer |
o
| Director |
o
| Promoter |
| Clarification of Response (if Necessary) |
| | |
| Last Name | First Name | Middle Name |
| Feldmann | Marc | |
| Street Address 1 | Street Address 2 |
| c/o 180 Life Sciences Corp. | 3000 El Camino Real, Bldg. 4, Suite 200 |
| City | State/Province/Country | ZIP/Postal Code |
| Palo Alto | CALIFORNIA | 94306 |
| Relationship: |
o
| Executive Officer |
x
| Director |
o
| Promoter |
| Clarification of Response (if Necessary) |
| | |
| Last Name | First Name | Middle Name |
| Steinman | Lawrence | |
| Street Address 1 | Street Address 2 |
| c/o 180 Life Sciences Corp. | 3000 El Camino Real, Bldg. 4, Suite 200 |
| City | State/Province/Country | ZIP/Postal Code |
| Palo Alto | CALIFORNIA | 94306 |
| Relationship: |
o
| Executive Officer |
x
| Director |
o
| Promoter |
| Clarification of Response (if Necessary) |
| | |
| Last Name | First Name | Middle Name |
| Gold | Larry | |
| Street Address 1 | Street Address 2 |
| c/o 180 Life Sciences Corp. | 3000 El Camino Real, Bldg. 4, Suite 200 |
| City | State/Province/Country | ZIP/Postal Code |
| Palo Alto | CALIFORNIA | 94306 |
| Relationship: |
o
| Executive Officer |
x
| Director |
o
| Promoter |
| Clarification of Response (if Necessary) |
| | |
| Last Name | First Name | Middle Name |
| McGovern | Donald | A. |
| Street Address 1 | Street Address 2 |
| c/o 180 Life Sciences Corp. | 3000 El Camino Real, Bldg. 4, Suite 200 |
| City | State/Province/Country | ZIP/Postal Code |
| Palo Alto | CALIFORNIA | 94306 |
| Relationship: |
o
| Executive Officer |
x
| Director |
o
| Promoter |
| Clarification of Response (if Necessary) |
| | |
| Last Name | First Name | Middle Name |
| Marrone | Pamela | |
| Street Address 1 | Street Address 2 |
| c/o 180 Life Sciences Corp. | 3000 El Camino Real, Bldg. 4, Suite 200 |
| City | State/Province/Country | ZIP/Postal Code |
| Palo Alto | CALIFORNIA | 94306 |
| Relationship: |
o
| Executive Officer |
x
| Director |
o
| Promoter |
| Clarification of Response (if Necessary) |
| | |
| Last Name | First Name | Middle Name |
| Knuettel | Francis | |
| Street Address 1 | Street Address 2 |
| c/o 180 Life Sciences Corp. | 3000 El Camino Real, Bldg. 4, Suite 200 |
| City | State/Province/Country | ZIP/Postal Code |
| Palo Alto | CALIFORNIA | 94306 |
| Relationship: |
o
| Executive Officer |
x
| Director |
o
| Promoter |
| Clarification of Response (if Necessary) |
| | |
| Last Name | First Name | Middle Name |
| DeLuca | Teresa | |
| Street Address 1 | Street Address 2 |
| c/o 180 Life Sciences Corp. | 3000 El Camino Real, Bldg. 4, Suite 200 |
| City | State/Province/Country | ZIP/Postal Code |
| Palo Alto | CALIFORNIA | 94306 |
| Relationship: |
o
| Executive Officer |
x
| Director |
o
| Promoter |
| Clarification of Response (if Necessary) |
| | |
| Last Name | First Name | Middle Name |
| Ray | Russel | T. |
| Street Address 1 | Street Address 2 |
| c/o 180 Life Sciences Corp. | 3000 El Camino Real, Bldg. 4, Suite 200 |
| City | State/Province/Country | ZIP/Postal Code |
| Palo Alto | CALIFORNIA | 94306 |
| Relationship: |
o
| Executive Officer |
x
| Director |
o
| Promoter |
| Clarification of Response (if Necessary) |
| | |
|
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| Agriculture | | Health Care |
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| Retailing |
| | Banking & Financial Services | |
x
| Biotechnology |
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| Restaurants |
| |
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| Commercial Banking | |
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| Health Insurance | | Technology |
| |
o
| Insurance | |
o
| Hospitals & Physicians | |
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| Computers |
| |
o
| Investing | |
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| Pharmaceuticals | |
o
| Telecommunications |
| |
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| Investment Banking | |
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| Other Health Care | |
o
| Other Technology |
| |
o
| Pooled Investment Fund
| | | | | Travel |
| |
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| Other Banking & Financial Services |
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| Manufacturing | |
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| Airlines & Airports |
| | Real Estate | |
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| Lodging & Conventions |
| |
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| Commercial | |
o
| Tourism & Travel Services |
| |
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| Construction | |
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| Other Travel |
| |
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| REITS & Finance |
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| Other |
| |
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| Residential | |
| |
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| Other Real Estate | |
|
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| Business Services | |
| | Energy | |
| |
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| Coal Mining | |
| |
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| Electric Utilities | |
| |
o
| Energy Conservation | |
| |
o
| Environmental Services | |
| |
o
| Oil & Gas | |
| |
o
| Other Energy | |
| Revenue Range | Aggregate Net Asset Value Range |
|
o
| No Revenues |
o
| No Aggregate Net Asset Value |
|
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| $1 - $1,000,000 |
o
| $1 - $5,000,000 |
|
o
| $1,000,001 - $5,000,000 |
o
| $5,000,001 - $25,000,000 |
|
o
| $5,000,001 - $25,000,000 |
o
| $25,000,001 - $50,000,000 |
|
o
| $25,000,001 - $100,000,000 |
o
| $50,000,001 - $100,000,000 |
|
o
| Over $100,000,000 |
o
| Over $100,000,000 |
|
x
| Decline to Disclose |
o
| Decline to Disclose |
|
o
| Not Applicable |
o
| Not Applicable |
| 6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply) |
|
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| Rule 504(b)(1) (not (i), (ii) or (iii)) |
o
| Rule 505 |
|
o
| Rule 504 (b)(1)(i) |
x
| Rule 506(b) |
|
o
| Rule 504 (b)(1)(ii) |
o
| Rule 506(c) |
|
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| Rule 504 (b)(1)(iii) |
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| Securities Act Section 4(a)(5) |
| |
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| Investment Company Act Section 3(c) |
|
x
| New Notice | Date of First Sale | 2021-08-23 |
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| First Sale Yet to Occur |
| Does the Issuer intend this offering to last more than one year? |
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| Yes |
x
| No |
| 9. Type(s) of Securities Offered (select all that apply) |
|
o
| Pooled Investment Fund Interests |
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| Equity |
|
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| Tenant-in-Common Securities |
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| Debt |
|
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| Mineral Property Securities |
x
| Option, Warrant or Other Right to Acquire Another Security |
|
x
| Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security |
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| Other (describe) |
| | |
| 10. Business Combination Transaction |
| Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? |
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| Yes |
x
| No |
| |
| Clarification of Response (if Necessary) | |
| |
| Minimum investment accepted from any outside investor | $ 189498 USD |
| Recipient | Recipient CRD Number |
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| None |
| Maxim Group LLC | 120708 |
| (Associated) Broker or Dealer |
x
| None | (Associated) Broker or Dealer CRD Number |
x
| None |
| | |
| Street Address 1 | Street Address 2 |
| 300 PARK AVENUE | 16TH FLOOR |
| City | State/Province/Country | ZIP/Postal Code |
| NEW YORK | NEW YORK | 10022 |
| State(s) of Solicitation |
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| All States |
x
| Foreign/Non-US |
CONNECTICUT
ILLINOIS
NEW YORK
|
| 13. Offering and Sales Amounts |
| Total Offering Amount | $ 15000000 USD |
o
Indefinite |
| Total Amount Sold | $ 15000000 USD | |
| Total Remaining to be Sold | $ 0 USD |
o
Indefinite |
| |
| Clarification of Response (if Necessary) |
| |
|
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| Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering
| |
| | Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: | 12 |
| 15. Sales Commissions & Finders’ Fees Expenses |
Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
|
| Sales Commissions | $ 1050000 USD |
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| Estimate |
| Finders' Fees | $ 0 USD |
o
| Estimate |
| |
| Clarification of Response (if Necessary) |
| |
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
|
| | $ 0 USD |
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