SEC Form 4 · accession 0001493152-16-009589
VIVOS INC · RDGL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Carlton M Cadwell
Director · 10% Owner
Period of report
May 9, 2016
Accepted (ET)
May 10, 2016 · 4:12 pm EDT
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 | May 9, 2016 | J | 31,296 | A | May 9, 2016 | — | Common Stock | 31,296,000 | 751,292 | D |
| Series A Convertible Preferred StockF3,F2 | $0.005 | holding | — | — | — | — | — | Common Stock | 148,309,000 | 148,309 | I |
Explanation of responses
- F1In consideration for 31,296 shares of Series A Convertible Preferred Stock, the Reporting Person exchanged a promissory note with an outstanding balance of $150,219.10, which amount includes all principal and accrued but unpaid interest thereon.
- F2The Series A Convertible Preferred Stock has no expiration date.
- F3Date(s) of issuance.