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ALPINE INCOME PROPERTY TRUST, INC.
Date Filed :
Jun 18, 2024
View Exhibits
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
OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response:
0.5
1. Name and Address of Reporting Person
*
Mays Philip
(Last)
(First)
(Middle)
369 N. NEW YORK AVE
SUITE 201
(Street)
WINTER PARK
FL
32789
(City)
(State)
(Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/17/2024
3. Issuer Name
and
Ticker or Trading Symbol
Alpine Income Property Trust, Inc.
[
PINE
]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director
10% Owner
X
Officer (give title below)
Other (specify below)
SVP, CFO & Treasurer
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)
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:
Remarks:
No securities are beneficially owned. Mr. Mays also serves as the Senior Vice President, Chief Financial Officer and Treasurer of CTO Realty Growth, Inc. ("CTO"). Mr. Mays disclaims beneficial ownership of all equity securities of Alpine Income Property Trust, Inc. (the "Issuer") that are or may be beneficially owned by CTO or any of its affiliates. Pursuant to Rule 16a-1(a)(4) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), this filing shall not be deemed an admission that Mr. Mays is, for purposes of Section 16 of the Exchange Act or otherwise, the beneficial owner of any equity securities of the Issuer that are or may be beneficially owned by CTO or any of its affiliates. Daniel E. Smith is signing on behalf of Mr. Mays pursuant to the Power of Attorney, dated June 17, 2024, which is attached hereto as Exhibit 24.
No securities are beneficially owned.
/s/ Daniel E. Smith, attorney-in-fact for Philip R. Mays
06/18/2024
** 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.
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