Form SC 13G - Statement of Beneficial Ownership by Certain Investors
30 September 2024 - 9:10PM
Edgar (US Regulatory)
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. )*
Chanson International Holding
(Name of Issuer)
Class A ordinary shares, par value $0.001 per
share
(Title of Class of Securities)
G2104U107
(CUSIP Number)
September 24, 2024
(Date of Event Which Requires Filing of This Statement)
Check the appropriate box to designate the rule
pursuant to which this Schedule is filed:
* | The remainder of this cover page shall be filled out for
a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment
containing information which would alter the disclosures provided in a prior cover page. |
The information required in the remainder of this
cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”)
or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see
the Notes).
1. |
Names of Reporting Persons
Xiaodi Han |
2. |
Check the Appropriate Box if a Member of a Group
(a) ☐
(b) ☐ |
3. |
SEC Use Only
|
4. |
Citizenship or Place of Organization
China |
Number of Shares
Beneficially
Owned by
Each Reporting
Person With: |
5. |
Sole Voting Power
1,024,777* |
6. |
Shared Voting Power
0 |
7. |
Sole Dispositive Power
1,024,777* |
8. |
Shared Dispositive Power
0 |
9. |
Aggregate Amount Beneficially Owned by Each Reporting
Person
1,024,777* |
10. |
Check if the Aggregate Amount in Row (9) Excludes Certain Shares ☐
|
11. |
Percent of Class Represented by Amount in Row
(9)
6.3%** |
12. |
Type of Reporting Person
IN |
|
* |
Represents 1,024,777 Class A ordinary shares, par value $0.001 per share (“Class A Ordinary Shares”), that are held by Xiaodi Han as of the date hereof, which includes 407,493 Class A Ordinary Shares issued to Xiaodi Han upon the exercise of common warrants (“Common Warrants”) granted to Xiaodi Han. |
|
** |
Pursuant to Rule 13d-3(d)(1) under the Securities Exchange Act of 1934, as amended, the denominator of this percentage is 16,143,063 Class A Ordinary Shares outstanding as of the date hereof, which includes 407,493 Class A Ordinary Shares issued to Xiaodi Han upon the exercise of the Common Warrants described above. |
ITEM 1.
(a) Name of Issuer: Chanson
International Holding
(b) Address of Issuer’s Principal
Executive Offices: B9 Xinjiang Chuangbo Zhigu Industrial Park, No. 100 Guangyuan Road, Shuimogou District, Urumqi, Xinjiang, China 830017
ITEM 2.
2(a) Name of Person Filing:
Xiaodi Han
2(b) Address of Principal
Business Office, or if None, Residence:
Building B5, No. 505, Lijiang East Road,
Huangdao District, Qingdao City, Shandong Province, China 266500
2(c) Citizenship:
China
2(d) Title of Class of Securities:
Class A ordinary shares, par value $0.001
per share
2(e) CUSIP Number:
G2104U107
ITEM 3. IF THIS STATEMENT IS FILED PURSUANT
TO SS.240.13d-1(b) OR 240.13d-2(b) OR (c), CHECK WHETHER THE PERSON FILING IS A:
Not Applicable.
ITEM 4. OWNERSHIP.
The information requested in these paragraphs
is incorporated herein by reference to the cover pages to this Schedule 13G.
ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF
A CLASS.
Not applicable.
ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT
ON BEHALF OF ANOTHER PERSON.
Not applicable.
ITEM 7. IDENTIFICATION AND CLASSIFICATION OF
THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY.
Not applicable.
ITEM 8. IDENTIFICATION AND CLASSIFICATION OF
MEMBERS OF THE GROUP.
Not applicable.
ITEM 9. NOTICE OF DISSOLUTION OF GROUP.
Not applicable.
ITEM 10. CERTIFICATIONS.
By signing below I certify
that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or
with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection
with or as a participant in any transaction having that purpose or effect, other than activities solely in connection with a nomination
under § 240.14a-11.
SIGNATURE
After reasonable inquiry and
to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
Date: September 30, 2024
|
By: |
/s/ Xiaodi Han |
|
Name: |
Xiaodi Han |
The original statement shall
be signed by each person on whose behalf the statement is filed or his authorized representative. If the statement is signed on behalf
of a person by his authorized representative other than an executive officer or general partner of the filing person, evidence of the
representative’s authority to sign on behalf of such person shall be filed with the statement, provided, however, that a power of
attorney for this purpose which is already on file with the Commission may be incorporated by reference. The name and any title of each
person who signs the statement shall be typed or printed beneath his signature.
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