# EDGAR Filing Document

**Accession Number:** 0001966205
**File Stem:** 0001104659-23-023375
**Filing Date:** 2023-2
**Character Count:** 8245
**Document Hash:** a3a947a26f7e0d010385706c8915130c
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001104659-23-023375.hdr.sgml**: 20230217

**ACCESSION NUMBER**: 0001104659-23-023375

**CONFORMED SUBMISSION TYPE**: 3

**PUBLIC DOCUMENT COUNT**: 2

**CONFORMED PERIOD OF REPORT**: 20230215

**FILED AS OF DATE**: 20230217

**DATE AS OF CHANGE**: 20230217

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Draizin Adam R.
- **CENTRAL INDEX KEY:** 0001966205

**FILING VALUES:**
- **FORM TYPE:** 3
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 000-56422
- **FILM NUMBER:** 23644256

**MAIL ADDRESS:**
- **STREET 1:** 2801 E. CAMELBACK ROAD #180
- **CITY:** PHOENIX
- **STATE:** AZ
- **ZIP:** 85016
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** TILT Holdings Inc.
- **CENTRAL INDEX KEY:** 0001761510
- **STANDARD INDUSTRIAL CLASSIFICATION:** CIGARETTES [2111]
- **IRS NUMBER:** 000000000
- **STATE OF INCORPORATION:** A1
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** SUITE 2200, 885 WEST GEORGIA STREET
- **CITY:** VANCOUVER
- **STATE:** A1
- **ZIP:** V6C 3E8
- **BUSINESS PHONE:** (647) 777-1713

**MAIL ADDRESS:**
- **STREET 1:** SUITE 2200, 885 WEST GEORGIA STREET
- **CITY:** VANCOUVER
- **STATE:** A1
- **ZIP:** V6C 3E8

## Exhibit 24.1

**Exhibit 24.1**

**LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS**

Know all by these presents, that the undersigned hereby constitutes and appoints **<u>Mark Higgins</u>** as the undersigned's true and lawful attorney-in-fact to:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1. execute for and on behalf of the undersigned, in the undersigned's capacity as an officer or director or both of TILT Holdings Inc. (the "***Company***"), Forms 3, 4 and 5 (and any amendments thereto) in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended (the "***Exchange Act***"), and the rules thereunder;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2. do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4 or 5, complete and execute any amendments thereto, and timely file such form with the U.S. Securities and Exchange Commission (the "***SEC***") and any securities exchange or similar authority, including without limitation the execution and filing of a Form ID or any other documents necessary or appropriate to enable the undersigned to file the Forms 3, 4 and 5 electronically with the SEC; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;3. take any other action in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by or for, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Limited Power of Attorney shall be in such form and shall contain such information and disclosure as such attorney-in-fact may approve in such attorney-in- fact's discretion.

The undersigned hereby grants to such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever required, necessary or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this Limited Power of Attorney and the rights and powers herein granted.

The undersigned acknowledges that such attorney-in-fact, in serving in such capacity at the request and on the behalf of the undersigned, is not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with, or any liability for the failure to comply with, any provision of Section 16 of the Exchange Act.

This Limited Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 or 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to such attorney-in-fact.

[SIGNATURE PAGE FOLLOWS]

IN WITNESS WHEREOF, the undersigned has executed this Limited Power of Attorney as of this 13th day of February, 2023.

---

| |
|:---|
| Signed and acknowledged: |
| /s/ Adam R. Draizin |
| Adam R. Draizin |

---

[Signature Page to Limited Power of Attorney for Section 16 Reporting Obligations]

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 3

### INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Draizin Adam R.<br><sub>(Last) (First) (Middle)</sub><br>C/O TILT HOLDINGS INC.<br>2801 E. CAMELBACK ROAD #180<br><sub>(Street)</sub><br>PHOENIX, AZ 85016<br><sub>(City) (State) (Zip)</sub> | **3. Issuer Name and Ticker or Trading Symbol**<br>TILT Holdings Inc. [ TLLTF ] | **5. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  |
| **2. Date of Event Requiring Statement (Month/Day/Year)**<br>2023-02-15 | **4. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director   [ ] 10% Owner<br>[ ] Officer (give title below)   [ ] Other (specify below)<br>_ _ | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities Beneficially Owned

---

|  |  |  |  |
| --- | --- | --- | --- |
| 1. Title of Security | 2. Amount of Securities Beneficially Owned | 3. Ownership Form | 4. Nature of Indirect Beneficial Ownership |

---

## Table II - Derivative Securities Beneficially Owned

---

|  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Underlying Securities | 3. Title and Amount of Underlying Securities | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| LP Units of Jimmy Jang L.P. | <sup>(1)</sup> | <sup>(1)</sup> | Common shares, no par value | 2196569<sup>(1)</sup> | $0 | I | See Footnote<sup>(2)</sup> |
| Rights of Jimmy Jang L.P. | <sup>(1)</sup> | <sup>(1)</sup> | Common shares, no par value | 2196569<sup>(1)</sup> | $0 | I | See Footnote<sup>(2)</sup> |

---

### Footnotes:

(1) Each LP unit ("Unit") of Jimmy Jang L.P. ("Jimmy Jang"), a subsidiary of the Issuer, is convertible together with one right ("Right") of Jimmy Jang for one share of common shares at any time upon request of the Reporting Person.

(2) The Rights and Units are held by Callisto Collaborations LLC.

**Remarks:**
Exhibit List: Exhibit 24.1 - Power of Attorney

**Signature:** /s/ Mark M. Higgins as attorney-in-fact for Adam R. Draizin  
**Date:** 2023-02-17

### Remarks:

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 4 (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.**