SEC Form 4 · accession 0001079974-15-000257
OMNI BIO PHARMACEUTICAL, INC. · OMBP
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Bohemian Investments LLC
10% Owner
Period of report
Apr 25, 2014
Accepted (ET)
Apr 9, 2015 · 6:10 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001389870
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible Note | $0.20 | Dec 12, 2014 | P | 2,500,000 | A | Dec 12, 2014 | Apr 24, 2015 | Common Stock | 2,500,000 | 11,000,000 | D |
| Convertible Note | $0.20 | Jan 30, 2015 | P | 2,500,000 | D | Apr 25, 2014 | Apr 24, 2015 | Common Stock | 10,000,000 | 11,000,000 | D |
| Convertible Note | $0.20 | Jan 30, 2015 | P | 2,500,000 | A | Apr 25, 2014 | Dec 17, 2019 | Common Stock | 10,000,000 | 11,000,000 | D |
| Convertible Note | $0.20 | Mar 12, 2015 | P | 1,500,000 | A | Apr 25, 2014 | Dec 17, 2019 | Common Stock | 11,500,000 | 12,500,000 | D |
Explanation of responses
- F1Advance of $500,000 under the previously disclosed $2,000,000 Secured Convertible Promissory Note resulting in total drawn principal of $2,000,000.
- F2Amendment and restatement of the previously reported $2,000,000 Secured Convertible Promissory Note for the purpose of extending the contractual conversion to December 17, 2019 and revising the conversion rights such that the principal and the accrued interest may automatically convert at a purchase price per share equal to the lessor of $0.20 or the lowest price paid for new securities in a minimum $6,000,000 capital raise.
- F3Amend and restatement of the previously reported $2,000,000 Secured Convertible Promissory Note for the purpose of increasing the principal of the note by $300,000 for a total of $2,300,000 and for advancing the $300,000.