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
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1. Name and Address of Reporting Person*
Norstrud Andrew James

(Last) (First) (Middle)
C/O GROVE INC.
1710 WHITNEY MESA DRIVE

(Street)
HENDERSON NV 89014

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/24/2021
3. Issuer Name and Ticker or Trading Symbol
GROVE, INC. [ GRVI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
CFO
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 305,556(1) 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 Option Grant (1)(2) (2) Common Stock 166,667 (2) D
Employee Stock Option Grant (1)(3) (3) Common Stock 388,888 (3) D
Explanation of Responses:
1. Subject to a 180-day lockup period in connection with the Issuer's initial public offering.
2. 159,773 options are vested and shall be exercisable for a price of $1.53 per option share for 10 years from June 1, 2019. 6,894 options shall vest on June 30, 2021 and be exercisable for a price of $1.53 per option share for ten years from June 1, 2019.
3. 27,263 options are vested and shall be exercisable for a price of $1.53 per option share for 10 years from February 1, 2021. 361,625 options shall vest on a monthly basis over a two year period and be exercisable for a price of $1.53 per option share for ten years from February 1, 2021.
Remarks:
/s/ Andrew Norstrud 06/24/2021
** 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.
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