# EDGAR Filing Document

**Accession Number:** 0001776738
**File Stem:** 0001567619-23-003015
**Filing Date:** 2023-2
**Character Count:** 6697
**Document Hash:** 9b549a8691b937d975816bdf7e10d424
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001567619-23-003015.hdr.sgml**: 20230214

**ACCESSION NUMBER**: 0001567619-23-003015

**CONFORMED SUBMISSION TYPE**: 5

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20221231

**FILED AS OF DATE**: 20230214

**DATE AS OF CHANGE**: 20230214

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** VITA NICHOLAS
- **CENTRAL INDEX KEY:** 0001907623

**FILING VALUES:**
- **FORM TYPE:** 5
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 000-56294
- **FILM NUMBER:** 23633396

**MAIL ADDRESS:**
- **STREET 1:** C/O COLUMBIA CARE INC.
- **STREET 2:** 680 FIFTH AVENUE, 24TH FLOOR
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10019
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Columbia Care Inc.
- **CENTRAL INDEX KEY:** 0001776738
- **STANDARD INDUSTRIAL CLASSIFICATION:** AGRICULTURE PRODUCTION - CROPS [0100]
- **IRS NUMBER:** 981488978
- **STATE OF INCORPORATION:** A1
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 680 FIFTH AVENUE, 24TH FLOOR
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10019
- **BUSINESS PHONE:** 2125543424

**MAIL ADDRESS:**
- **STREET 1:** 680 FIFTH AVENUE, 24TH FLOOR
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10019

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

## FORM 5

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>VITA NICHOLAS<br><sub>(Last) (First) (Middle)</sub><br>C/O COLUMBIA CARE INC.<br>680 FIFTH AVENUE, 24TH FLOOR<br><sub>(Street)</sub><br>NEW YORK, NY 10019<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2022-12-31 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_CEO_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>Columbia Care Inc. [ CCHW ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<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

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Shares | 2022-01-05 |  | G |  | 231000 | D | $0.00 | 35627075 | I | Held by Vita Holdings LLC<sup>(1)</sup> |
| Common Shares | 2022-03-10 |  | G |  | 800000 | D | $0.00 | 34827075 | I | Held by Vita Holdings LLC<sup>(1)</sup> |
| Common Shares | 2022-05-19 |  | G |  | 400000 | D | $0.00 | 34427075 | I | Held by Vita Holdings LLC<sup>(1)</sup> |
| Common Shares | 2022-05-20 |  | G |  | 400000 | D | $0.00 | 34027075 | I | Held by Vita Holdings LLC<sup>(1)</sup> |
| Common Shares | 2022-06-13 |  | G |  | 400000 | D | $0.00 | 33627075 | I | Held by Vita Holdings LLC<sup>(1)</sup> |
| Common Shares | 2022-08-30 |  | G |  | 400000 | D | $0.00 | 33227075 | I | Held by Vita Holdings LLC<sup>(1)</sup> |
| Common Shares | 2022-10-26 |  | G |  | 1400000 | D | $0.00 | 31827075 | I | Held by Vita Holdings LLC<sup>(1)</sup> |
| Common Shares | 2022-12-28 |  | G |  | 6400000 | D | $0.00 | 25427075 | I | Held by Vita Holdings LLC<sup>(1)</sup> |
| Common Shares |  |  |  |  |  |  |  | 635247 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

---

### Footnotes:

(1) Held by Vita Holdings LLC, a company owned and controlled by the reporting person.

**Remarks:**
Transactions represent charitable contributions of shares by the Reporting Person for genetic and medical research, educational and other philanthropic purposes.

**Signature:** /s/ David Sirolly as attorney-in-fact for Nicholas Vita  
**Date:** 2023-02-14

### 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.**