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Robert Rico – ‘3’ for 2/7/17 re: Grand Havana Inc.

On:  Friday, 12/1/17, at 4:46pm ET   ·   For:  2/7/17   ·   Accession #:  1264931-17-117   ·   File #:  0-55037

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  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

12/01/17  Robert Rico                       3                      1:4K   Grand Havana Inc.                 Bongiovanni Michael J

Initial Statement of Beneficial Ownership of Securities by an Insider   —   Form 3   —   SEA’34
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 3           Ownership Document -- form3rico.xml/2.6             HTML      3K 




        

This ‘3’ Document is an XML Data File that may be rendered in various formats:

  Form 3    –   Plain Text   –  SEC Website  –  EDGAR System  –    XML Data    –  <?xml?> File
 

 
SEC Info rendering:  Ownership Document
 
FORM 3UNITED 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*
ROBERT RICO

(Last)(First)(Middle)
407 LINCOLN ROAD
SUITE 12R

(Street)
MIAMI BEACHFL33139

(City)(State)(Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
2/7/17
3. Issuer Name and Ticker or Trading Symbol
GRAND HAVANA INC. [ GHAV ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
XDirectorX10% Owner
XOfficer (give title below) Other (specify below)
CEO
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
XForm 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 Shares4,900,000D
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 ExercisableExpiration DateTitleAmount or Number of Shares
Series A Preferred 3/14/17 (1)Common Shares (1)10 (1)D
Explanation of Responses:
(1)  Each Series A preferred Share is convertible into a number of common shares equal 2% (two percent) of the number of issued and outstanding shares at the time of conversion. The conversion right has no expiration.
/s/ ROBERT RICO 12/1/17
** Signature of Reporting PersonDate
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.

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Filing Submission 0001264931-17-000117   –   Alternative Formats (Word / Rich Text, HTML, Plain Text, et al.)

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