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*
Scatterday Mark

(Last) (First) (Middle)
C/O SNELL & WILMER L.L.P.
350 S. GRAND AVENUE SUITE 3100

(Street)
LOS ANGELES CA 90071

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/15/2023
3. Issuer Name and Ticker or Trading Symbol
TILT Holdings Inc. [ TLLTF ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 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)
Common Stock, no par value 1,300,000 D
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
Employee Stock Options (right to buy) (1) 11/21/2029(2) Common stock, no par value 1,666,667(1) 0.65(3) D
LP Units of Jimmy Jang L.P. (4) (4) Common stock, no par value 27,182,540(4) 0 I See Footnote(5)
Rights of TILT Holdings Inc. (4) (4) Common stock, no par value 27,182,540(4) 0 I See Footnote(6)
Common Stock Warrants (right to buy) (7) 11/01/2022 Common stock, no par value 45,539,951(8) 0.0708 I See Footnote(9)
Explanation of Responses:
1. Each option is exercisable for one share of common stock, no par value ("Common Stock"), of TILT Holdings Inc. (the "Issuer"). The options are fully vested.
2. The options will expire on the earlier of (i) November 21, 2029 and (ii) the date that is three months after the termination of the Reporting Person's services to the Issuer.
3. The exercise price of the options is expressed in Canadian dollars.
4. Each LP unit ("Unit") of Jimmy Jang L.P. ("Jimmy Jang"), a subsidiary of the Issuer, is convertible together with one right ("Right") of the Issuer for one share of Common Stock at any time upon request of the Reporting Person.
5. The Units are held by Mak One LLLP ("Mak One"), the partnership interests of which are owned 100% by the Reporting Person.
6. The Rights are held by Mak One.
7. The warrants were issued on February 15, 2023 and were immediately exercisable and expire on February 15, 2030.
8. Each warrant is exercisable for one share of Common Stock.
9. The warrants are held by Mak One.
Remarks:
Exhibit List: Exhibit 24.1 - Power of Attorney
/s/ Mark Scatterday 02/27/2023
** 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.