SEC Form 4 · accession 0001179110-15-012643
ACTIVECARE, INC. · ACAR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Period of report
Aug 6, 2015
Accepted (ET)
Aug 26, 2015 · 12:27 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,F2 | Aug 6, 2015 | J | 750,000 | — | A | 10,107,579 | I | By ADP Management Corporation |
| Common StockF3,F2 | Aug 6, 2015 | J | 737,132 | — | D | 9,370,447 | I | By ADP Management Corporation |
| Common StockF4 | holding | — | — | — | 4,750 | I | By Purizer Corporation | |
| Common StockF5 | holding | — | — | — | 1,212,500 | I | By Schwartz Group, LLC | |
| Common Stock | holding | — | — | — | 37,006 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The shares of common stock were issued to David Derrick as a severance payment and in consideration of Mr. Derrick's willingness to continue to guaranty certain obligations of issuer; however, at Mr. Derrick's request, such shares were issued in the name of ADP Management Corporation.
- F2ADP Management Corporation is owned and controlled, in part, by David Derrick. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.
- F3The shares of common stock were transferred to third parties pursuant to purchase agreements which contained contingent future obligations to transfer additional shares of common stock to such third parties for no additional consideration.
- F4Purizer Corporation is owned and controlled, in part, by David Derrick. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.
- F5Schwartz Group, LLC is owned, in part, by ADP Management Corporation. The Reporting Persons disclaim beneficial ownership of these securities except to the extent of their respective pecuniary interests therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.