SEC Form 4 · accession 0001144204-17-065714

UNIVERSAL BIOSENSORS INC · UBI

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Table I — non-derivative securities

Table II — derivative securities

Explanation of responses

• F1Traded as Chess Depository Interests ("CDIs") on the Australian Stock Exchange. CDIs represent beneficial interests in the common stock held by CHESS Depository Nominees Pty Ltd.
• F2The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $0.265 to $0.270, inclusive. The Reporting Person undertakes to provide to Universal Biosensors, Inc. ("UBI"), any security holder of UBI, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote (2) to this Form 4.
• F3The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $0.275 to $0.300. The Reporting Person undertakes to provide to Universal Biosensors, Inc. ("UBI"), any security holder of UBI, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote (3) to this Form 4.
• F4The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $0.290 to $0.300. The Reporting Person undertakes to provide to Universal Biosensors, Inc. ("UBI"), any security holder of UBI, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote (4) to this Form 4.
• F5The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions all at a price of $0.300. The Reporting Person undertakes to provide to Universal Biosensors, Inc. ("UBI"), any security holder of UBI, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote (5) to this Form 4.
• F6The price per share of the common stock reported is stated in Australian dollars, as converted from a U.S. dollar price on the date of the transaction.
• F7The Reporting Person is a director of Viburnum Funds Pty Ltd ("Viburnum"), which is the manager of each of VF Strategic Equities Fund ("Strategic Fund") and VF High Conviction Fund ("Conviction Fund"), the direct beneficial owners of the common stock. The Reporting Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of the common stock held by Strategic Fund and Conviction Fund, except to the extent of his pecuniary interest therein.
• F8Viburnum, as the manager of Strategic Fund and Conviction Fund, may be deemed to beneficially own 31,525,653 shares of common stock, which consists of 20,091,652 and 11,434,001 shares of common stock held by Strategic Fund and Conviction Fund, respectively. Viburnum, as the manager of each of Strategic Fund and Conviction Fund, shares voting and dispositive power over, and may be deemed to beneficially own, the common stock held by the foregoing entities. The Reporting Person shares voting and dispositive power over, and may be deemed to beneficially own, the common stock held by the foregoing entities due to the Reporting Person serving as a director of Viburnum.
• F9Craig E. and Phylis Coleman are the trustees of the Coleman Super Fund, of which Mr. Coleman is a potential beneficiary.