Ownership Submission
FORM 3
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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 *
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Carlson Randy Scott
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2. Date of Event Requiring Statement (Month/Day/Year)
2024-11-07
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3. Issuer Name and Ticker or Trading Symbol
PSQ Holdings, Inc. [PSQH]
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(Last)
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(First)
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(Middle)
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C/O PSQ HOLDINGS, INC. , 250 S. AUSTRALIAN AVENUE, SUITE 1300
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
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_____ 10% Owner
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_____ Officer (give title below)
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_____ Other (specify below)
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Chief Technology Officer /
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5. If Amendment, Date Original Filed (Month/Day/Year)
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(Street)
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WEST PALM BEACH
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FL
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33401
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6. Individual or Join/Group Filing (Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
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2. Amount of Securities Beneficially Owned
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3. Ownership Form: Direct (D) or Indirect (I)
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4. Nature of Indirect Beneficial Ownership
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
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2. Date Exercisable and Expiration Date
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3. Title and Amount of Securities Underlying Derivative Security
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
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6. Nature of Indirect Beneficial Ownership
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Date Exercisable
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Expriation Date
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Title
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Amount or Number of Shares
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Reporting Owners
Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Carlson Randy Scott
C/O PSQ HOLDINGS, INC.
250 S. AUSTRALIAN AVENUE, SUITE 1300
WEST PALM BEACH, FL33401
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Chief Technology Officer
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Signatures
/s/ Nelson Mullins Riley & Scarborough LLP, Attorney-in-Fact
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2024-11-18
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**Signature of Reporting Person
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Date
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Explanation of Responses:
(*)
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If the form is filed by more than one reporting person, see Instruction 5(b)(v).
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(**)
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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(1)
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Certain of the securities reported in Column 2 of Table I are restricted stock units ("RSU"), which represent the contingent right to receive one share of the Issuer's Class A common stock, par value $0.0001 per share. The RSU award vests as follows: 16,666 RSUs vested on September 25, 2024, 16,667 RSUs will vest on September 25, 2025, and 16,667 RSUs will vest on September 25, 2026, subject to the terms and conditions of the RSU award and the Issuer's 2023 Stock Incentive Plan.
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