Initial Statement of Beneficial Ownership (3)
February 14 2019 - 4:57PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
0.5
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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
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1. Name and Address of Reporting Person
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Pacific Sequoia Holdings LLC
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2. Date of Event Requiring Statement (MM/DD/YYYY)
12/26/2018
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3. Issuer Name
and
Ticker or Trading Symbol
Global Clean Energy Holdings, Inc. [GCEH]
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(Last)
(First)
(Middle)
250 UNIVERSITY AVENUE
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
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X
___ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Street)
PALO ALTO, CA 94301
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person
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X
_ 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
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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40000000
(1)
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D
(2)
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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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)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Explanation of Responses:
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(1)
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Jeffrey S. Skoll, the indirect sole member of Pacific Sequoia Holdings, LLC ("PSH"), may be deemed to share the power to direct the voting and disposition of the shares held by PSH. Each of the reporting persons disclaims beneficial ownership of the reported shares except to the extent of his or its respective pecuniary interest therein.
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(2)
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The shares were assigned to PSH, AllianceBernstein Venture Fund I, L.P. and Growthworks Canadian Fund Ltd. (collectively, the "Collateral Agent") pursuant to an assignment agreement. The Collateral Agent was designated as collateral agent pursuant to a guarantee and security agreement by and between the Collateral Agent and other parties thereto (the "Security Agreement"). The shares were assigned to the Collateral Agent in partial satisfaction of the obligations owed under the Security Agreement.
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Reporting Owners
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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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Pacific Sequoia Holdings LLC
250 UNIVERSITY AVENUE
PALO ALTO, CA 94301
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X
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SKOLL JEFFREY S
250 UNIVERSITY AVENUE
PALO ALTO, CA 94301
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X
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Signatures
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/s/ Eric Techel, Manager, Pacific Sequoia Holdings
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2/14/2019
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**
Signature of Reporting Person
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Date
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/s/ Eric Techel, by power of attorney
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2/14/2019
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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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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Note:
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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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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 control number.
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