SEC Form 4 · accession 0001179110-15-007612
ACTIVECARE, INC. · ACAR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owners
Jeffrey S Peterson
Officer — VP Finance · Director · 10% Owner
Tyumen Holdings, LLC
10% Owner
Period of report
Apr 15, 2015
Accepted (ET)
May 12, 2015 · 3:06 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001429896
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Apr 15, 2015 | A | 18,121 | — | A | 6,632,288 | I | By Tyumen Holdings, LLC |
| Common StockF2 | Apr 15, 2015 | A | 192,891 | $0.281 | A | 2,759,277 | I | By Bluestone Advisors, LLC |
| Common Stock | holding | — | — | — | 2,862,966 | I | By Wynnman's Hill, LLC | |
| Common Stock | holding | — | — | — | 20,270 | I | By Banyan Investment Company, LLC | |
| Common Stock | holding | — | — | — | 239,259 | I | By Keystone Partners, LLC | |
| Common Stock | holding | — | — | — | 156,250 | I | By RimRock Capital |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The shares of common stock were granted to pay dividends on shares of Series D Preferred Stock which were originally issued as compensation for services provided by Jeff Peterson; however, at Mr. Peterson's request, the shares of Series D Preferred Stock were issued in the name of Tyumen Holdings, LLC.
- F2The shares of common stock were granted to pay accrued compensation for services rendered by Jeff Peterson to issuer; however, at Mr. Peterson's request, such shares were issued in the name of Bluestone Advisors, LLC.