PSQ Holdings Inc.

12/11/2024 | Press release | Distributed by Public on 12/11/2024 20:02

Statement of Changes in Beneficial Ownership (Form 4)

Ownership Submission
FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN 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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(Print or Type Responses)
1. Name and Address of Reporting Person *
Seifert Michael Stephen
2. Issuer Name and Ticker or Trading Symbol
PSQ Holdings, Inc. [PSQH]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner
__X__ Officer (give title below) _____ Other (specify below)
Founder, President, CEO
(Last) (First) (Middle)
C/O PSQ HOLDINGS, INC., 250 S. AUSTRALIAN AVENUE, SUITE 1300
3. Date of Earliest Transaction (Month/Day/Year)
09/25/2023
(Street)
WEST PALM BEACH, FL 33401
4. If Amendment, Date 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
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Class A Common Stock, par value $0.0001 per share 09/25/2023 A 82,500 A $ 0 82,500(1) D
Class A Common Stock, par value $0.0001 per share 09/25/2023 A 50,000 A $ 0 50,000(2)(3) I By spouse
Class A Common Stock, par value $0.0001 per share 09/25/2024 F 3,964 D $2.41 46,036(3)(4) I By spouse
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(Month/Day/Year)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares

Reporting Owners

Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Seifert Michael Stephen
C/O PSQ HOLDINGS, INC.
250 S. AUSTRALIAN AVENUE, SUITE 1300
WEST PALM BEACH, FL 33401
X X Founder, President, CEO

Signatures

/s/ Michael Seifert 12/11/2024
**Signature of Reporting Person Date

Explanation of Responses:

* If the form is filed by more than one reporting person, see Instruction 4(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).
(1) The securities reported in Column 5 of Table I are restricted stock units ("RSU"). Each RSU represents a contingent right to receive one share of Class A common stock, par value $0.0001 per share (the "Class A Common Stock"). The 82,500 RSUs vest as follows: 27,500 RSUs vest on September 25, 2024, 27,500 RSUs vest on September 25, 2025, and 27,500 RSUs vest on September 25, 2026, subject to the terms and conditions of the RSU award and the Issuer's 2023 Stock Incentive Plan.
(2) The securities reported in Column 5 of Table I are RSUs. Each RSU represents a contingent right to receive one share of Class A Common Stock, subject to the terms and conditions of the RSU award and the Issuer's 2023 Stock Incentive Plan.
(3) The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
(4) Certain of the securities reported in Column 5 of Table I are RSUs. Each RSU represents a contingent right to receive one share of Class A Common Stock, subject to the terms and conditions of the RSU award and the Issuer's 2023 Stock Incentive Plan.

Remarks:
In addition to the securities report above, the reporting person owns 3,213,678 shares of Class C common stock, par value $0.0001 per share (the "Class C Common Stock") of the Issuer, representing 100% of the outstanding Class C Common Stock.
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.