Form 3 Beverly Jeffrey

3 - Initial statement of beneficial ownership of securities

Published: 2015-09-08 11:16:28
Submitted: 2015-09-08
Period Ending In: 2015-05-13
f3051315beverly_growsolut.html OWNERSHIP DOCUMENT


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SEC FORM 3

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*
Beverly Jeffrey

(Last) (First) (Middle)
535 FIFTH AVENUE, 24TH FLOOR

(Street)
NEW YORK NY 10017

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/13/2015
3. Issuer Name and Ticker or Trading Symbol
GROW SOLUTIONS HOLDINGS, INC. [ GRSO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President
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 600,000 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
Explanation of Responses:
/s/ Jeffrey Beverly 09/08/2015
** 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.
1
f3051315beverly_growsolut.xml OWNERSHIP DOCUMENT
Schema Version:
X0206
Document Type:
3
Period Of Report:
2015-05-13
No Securities Owned:
0

Issuer

Issuer Cik
0001104265
Issuer Name
GROW SOLUTIONS HOLDINGS, INC.
Issuer Trading Symbol
GRSO

Reporting Owner

Reporting Owner Id

Rpt Owner Cik
0001652556
Rpt Owner Name
Beverly Jeffrey

Reporting Owner Address

Rpt Owner Street1
535 FIFTH AVENUE, 24TH FLOOR
Rpt Owner City
NEW YORK
Rpt Owner State
NY
Rpt Owner Zip Code
10017

Reporting Owner Relationship

Is Director
1
Is Officer
1
Is Ten Percent Owner
0
Is Other
0
Officer Title
President

Non Derivative Holding

Security Title
Common Stock
Shares Owned Following Transaction
600000
Direct Or Indirect Ownership
D

Owner Signature

Signature Name
/s/ Jeffrey Beverly
Signature Date
2015-09-08
Additional Files
FileSequenceDescriptionTypeSize
0001213900-15-006788.txt   Complete submission text file   3623
$GRSO

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