SEC Form 4 · accession 0001493152-18-013443
PetVivo Holdings, Inc. · PETV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John Lai
Officer — President, Chairman & CFO · Director · 10% Owner
Period of report
Jun 7, 2017
Accepted (ET)
Sep 19, 2018 · 10:05 am EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001512922
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jun 7, 2017 | D | 1,250,000 | $0.00 | D | 1,983,216 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock WarrantF2 | $0.30 | Jun 7, 2017 | A | 750,000 | A | Dec 31, 2017 | Jun 30, 2021 | Common Stock | 750,000 | 750,000 | D |
Explanation of responses
- F1The 1,250,000 shares of common stock were disposed of in consideration of Wesley Hayne becoming CEO of PetVivo Holdings, Inc. on June 7, 2017, and subsequently issued to Wesley Hayne pursuant to the terms of the agreed upon Escrow Agreement.
- F2The warrant for purchase of 750,000 shares of common stock vests semi-annually over two years in 187,500 increments, whereby each tranche expires two years after its vesting date.