Thursday, April 26, 2018 4:34:41 PM
FORM 5
[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
[ ] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
1. Name and Address of Reporting Person *
Heggenhougen Rolv
2. Issuer Name and Ticker or Trading Symbol
Canbiola, Inc. [CANB]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director __ X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
445 NE 12TH AVENUE
3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY)
12/31/2017
(Street)
FORT LAUDERDALE, FL 33301
(City) (State) (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)
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 Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3) 2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. 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)
Amount (A) or (D) Price
Common Stock 1/4/2017 S 100000 D $0.03 92541908 I By McKenzie Webster Ltd.
Common Stock 1/20/2017 S 100000 D $0.037 92541908 I By spouse, Linn Osnes
Common Stock 1/24/2017 S 50000 D $0.046 92541908 I By spouse, Linn Osnes
Common Stock 1/26/2017 S 100000 D $0.056 92541908 I By spouse, Linn Osnes
Common Stock 1/26/2017 S 100000 D $0.043 92541908 I By McKenzie Webster Ltd.
Common Stock 1/27/2017 S 100000 D $0.069 92541908 I By spouse, Linn Osnes
Common Stock 1/31/2017 S 200000 D $0.046 92541908 I By spouse, Linn Osnes
Common Stock 2/1/2017 S 50000 D $0.076 92541908 I By McKenzie Webster Ltd.
Common Stock 2/1/2017 S 10000 D $0.076 92541908 I By McKenzie Webster Ltd.
Common Stock 2/2/2017 S 35200 D $0.042 92541908 I By spouse, Linn Osnes
Common Stock 2/2/2017 S 200000 D $0.064 92541908 I By McKenzie Webster Ltd.
Common Stock 2/3/2017 S 114800 D $0.041 92541908 I By spouse, Linn Osnes
Common Stock 2/3/2017 S 50000 D $0.045 92541908 I By McKenzie Webster Ltd.
Common Stock 2/7/2017 S 50000 D $0.046 92541908 I By McKenzie Webster Ltd.
Common Stock 2/17/2017 S 200000 D $0.032 92541908 I By spouse, Linn Osnes
Common Stock 2/22/2017 S 100000 D $0.032 92541908 I By spouse, Linn Osnes
Common Stock 3/13/2017 S 200000 D $0.045 92541908 I By spouse, Linn Osnes
Common Stock 3/28/2017 S 100000 D $0.023 92541908 I By spouse, Linn Osnes
Common Stock 3/29/2017 S 100000 D $0.023 92541908 I By spouse, Linn Osnes
Common Stock 4/17/2017 S 200000 D $0.023 92541908 I By spouse, Linn Osnes
Common Stock 9/28/2017 S 200000 D $0.009 92541908 I By McKenzie Webster Ltd.
Common Stock 9/29/2017 S 125000 D $0.009 92541908 I By McKenzie Webster Ltd.
Common Stock 10/4/2017 S 125000 D $0.01 92541908 I By McKenzie Webster Ltd.
Common Stock 10/5/2017 S 100000 D $0.01 92541908 I By McKenzie Webster Ltd.
Common Stock 10/12/2017 S 400000 D $0.008 92541908 I By McKenzie Webster Ltd.
Common Stock 10/26/2017 S 200000 D $0.007 92541908 I By McKenzie Webster Ltd.
Common Stock 11/30/2017 C 50000000 A $0 92541908 I By McKenzie Webster Ltd.
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Trans. Date 3A. Deemed Execution Date, if any 4. Trans. 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
(MM/DD/YYYY) 7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4) 8. Price of Derivative Security
(Instr. 5) 9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year
(Instr. 4) 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4) 11. Nature of Indirect Beneficial Ownership
(Instr. 4)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
Reporting Owners
Reporting Owner Name / Address
Relationships
Director 10% Owner Officer Other
Heggenhougen Rolv
445 NE 12TH AVENUE
FORT LAUDERDALE, FL 33301
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