Forza X1 Inc.

02/08/2023 | Press release | Distributed by Public on 02/08/2023 17:24

Initial Statement of Beneficial Ownership - Form 3

Ownership Submission
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:3235-0104Expires:January 31, 2005Estimated average burden hours per response...0.5
1. Name and Address of Reporting Person *
Gunnerson Carrie L.
2. Date of Event Requiring Statement (Month/Day/Year)
2023-02-06
3. Issuer Name and Ticker or Trading Symbol
Forza X1, Inc. [FRZA]
(Last) (First) (Middle)
C/O FORZA X1, INC. , 3101 S. US HWY 1
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
Interim CFO/Interim PAO /
5. If Amendment, Date Original Filed(Month/Day/Year)
(Street)
FORT PIERCE FL 34982
6. Individual or Join/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Beneficially Owned
1.Title of Security 2. Amount of Securities Beneficially Owned 3. Ownership Form: Direct (D) or Indirect (I) 4. Nature of Indirect Beneficial Ownership
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security 2. Date Exercisable and Expiration Date 3. Title and Amount of Securities Underlying Derivative Security 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) 6. Nature of Indirect Beneficial Ownership
Date Exercisable Expriation Date Title Amount or Number of Shares

Reporting Owners

Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Gunnerson Carrie L.
C/O FORZA X1, INC.
3101 S. US HWY 1
FORT PIERCE, FL34982


Interim CFO/Interim PAO

Signatures

/s/ Carrie L. Gunnerson 2023-02-08
**Signature of Reporting Person Date

Explanation of Responses:

(*) 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).
(1) These options vest pro rata on a monthly basis over three years commencing on the one-month anniversary of date of grant
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for procedure.Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.