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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*
DUMONT MARC

(Last) (First) (Middle)
43 RUE DE LA PRETAIRE

(Street)
VERBIER V8 1936

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/16/2021
3. Issuer Name and Ticker or Trading Symbol
Gaucho Group Holdings, Inc. [ VINO ]
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)
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 30,000 D(1)
Common Stock 39,282 D(2)
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
Stock Option (3) 12/17/2022 Common Stock 3,334 $16.5 D
Stock Option (4) 01/31/2024 Common Stock 3,334 $5.78 D
Stock Option (5) 09/28/2025 Common Stock 6,667 $9.08 D
Explanation of Responses:
1. Owned by self, Vinciane Dumont and Catherine Dumont as joint tenants with rights of survivorship.
2. Owned by self, Patrick Dumont and Vinciane Dumont as joint tenants with rights of survivorship.
3. Options issued pursuant to the 2016 Equity Incentive Plan on 12/17/17 at $16.50 per share. 833 vest on 12/17/18; thereafter 208 vest every 3 months; exp. 12/17/22.
4. Options granted pursuant to the 2018 Equity Incentive Plan on 1/31/2019 at $5.78 per share. 833 vest on 1/31/20; thereafter 208 vest every 3 months; exp. 1/31/24.
5. Options issued pursuant to the 2018 Equity Incentive Plan on 9/28/20 at $9.08 per share. 1,667 vest on 9/28/21; thereafter 417 every 3 months; exp. 9/28/25.
/s/ Marc Dumont 04/19/2022
** 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.