SEC Form 4 · accession 0001415889-15-004025
VIVOS INC · RDGL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James C Katzaroff
Officer — CHIEF EXECUTIVE OFFICER · Director
Period of report
Dec 9, 2015
Accepted (ET)
Dec 10, 2015 · 9:28 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001449349
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A Convertible Preferred StockF1,F2 | $0.005 | Dec 9, 2015 | A | 100,000 | A | Dec 9, 2015 | — | Common Stock | 100,000,000 | 110,500 | D |
Explanation of responses
- F1Accrued compensation in the amount of $150,000 due to the Reporting Person was converted into Shares of Series A Convertible Preferred Stock, which issuance was approved by the Issuer's Board of Directors.
- F2The Series A Convertible Preferred Stock has no expiration date.