SEC Form 4 · accession 0001415889-18-001611
VIVOS INC · RDGL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael K Korenko
Officer — CEO AND PRESIDENT
Period of report
Oct 10, 2018
Accepted (ET)
Nov 13, 2018 · 6:00 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001449349
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Oct 24, 2018 | A | 28,197,136 | — | A | 34,427,136 | D | |
| Common StockF2 | Oct 10, 2018 | A | 3,600,000 | — | A | 38,027,136 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantsF1 | $0.01 | Oct 24, 2018 | A | 14,098,568 | A | Oct 24, 2018 | Oct 24, 2020 | Common Stock | 14,098,568 | 14,098,568 | D |
| OptionsF3 | $0.014 | Oct 24, 2018 | A | 64,961,214 | A | Oct 24, 2018 | Oct 24, 2025 | Common Stock | 64,961,214 | 64,961,214 | D |
| WarrantsF2 | $0.01 | Oct 10, 2018 | A | 1,800,000 | A | Oct 10, 2018 | Oct 10, 2020 | Common Stock | 1,800,000 | 1,800,000 | D |
Explanation of responses
- F1Represents securities issued in lieu of cash owed to the Reporting Person for past services rendered to the Issuer in his capacity as Chief Executive Officer and President.
- F2On October 10, 2018, in connection with a private placement consummated by the Issuer on such date, the Reporting Person agreed to terminate a bridge note with an outstanding balance of $15,000 ("Outstanding Balance") in exchange for the issuance of $18,000 of units, or 120% of the Outstanding Balance, consisting of 3,600,000 shares of the Issuer's common stock and warrants to purchase 1,800,000 shares of the Issuer's common stock.
- F3Represents securities issued to the Reporting Person as a bonus for services rendered to the Issuer in his capacity as Chief Executive Officer and President.