SEC Form 4 · accession 0001477932-17-006329
PREMIER BIOMEDICAL INC · BIEI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John Stanley Borza
Officer — Vice President · Director
Period of report
Dec 22, 2017
Accepted (ET)
Dec 28, 2017 · 7:25 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001515740
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | holding | — | — | — | 1,056,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant (right to buy) | $0.005 | Dec 22, 2017 | A | 7,250,000 | A | Dec 22, 2017 | Dec 22, 2024 | Common Stock | 7,250,000 | 7,250,000 | D |
| Warrant (right to buy) | $1.45 | holding | — | — | — | Jun 15, 2013 | Jan 15, 2020 | Common Stock | 1,120,000 | 1,120,000 | D |
| Warrant (right to buy) | $0.25 | holding | — | — | — | Jun 15, 2015 | Jan 15, 2022 | Common Stock | 1,200,000 | 1,200,000 | D |
| Warrant (right to buy) | $0.05 | holding | — | — | — | Dec 15, 2016 | Jun 15, 2026 | Common Stock | 600,000 | 600,000 | D |