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*
Aubrey de Lavenu Harold Andre

(Last) (First) (Middle)
300-3295 QUALITY WAY

(Street)
WINDSOR, ONTARIO, CANADA A6 N8T 3R9

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/12/2017
3. Issuer Name and Ticker or Trading Symbol
CEN BIOTECH INC [ CENBF ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
04/22/2021
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 13,321(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
Convertible Note 05/24/2016 (3) Common Stock 62,500(2) $1.6 D
Convertible Note 11/25/2016 (3) Common Stock 125,000(2) $1.6 D
Convertible Note 12/14/2016 (3) Common Stock 156,250(2) $1.6 D
Convertible Note 02/09/2017 (3) Common Stock 312,500(2) $1.6 D
Explanation of Responses:
1. Harold Aubrey de Lavenu (the "Reporting Person") was appointed to his position with CEN Biotech, Inc. (the "Issuer") on July 12, 2017 and owned 13,321 shares of the Issuer's common stock on such date. On April 2, 2021, the Issuer appointed the Reporting Person to serve as a Vice President of the Issuer effective as of April 2, 2021
2. Additionally the Reporting Person owned convertible notes on July 12, 2017, which the Reporting Person purchased from the Issuer which were at such time and still are convertible into 656,250 shares of the Issuer's common stock.
3. The convertible notes included in this table matured on May 12, 2018, November 25, 2018, December 14, 2018, and February 19, 2019, respectively, (the "Maturity Dates"), however, the ability to convert the notes into shares did not expire on the Maturity Dates of the notes.
/s/ Harold Aubrey de Lavenu 05/28/2021
** 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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