SEC Form 4/A · accession 0001614671-15-000014
PREMIER BIOMEDICAL INC · BIEI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
William A. Hartman
Officer — President, CEO · Director · 10% Owner
Period of report
Oct 21, 2015
Accepted (ET)
Oct 23, 2015 · 3:22 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001515740
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant (right to buy)F1,F2 | $0.05 | Oct 21, 2015 | J | 1,000,000 | A | Oct 7, 2015 | Oct 7, 2025 | Common Stock | 1,000,000 | 1,000,000 | D |
Explanation of responses
- F1The warrant, which was effective on October 7, 2015, but not issued until October 21, 2015, was granted in consideration for the reporting person's service to Premier Biomedical, Inc.
- F2One half of the shares underlying the warrant shall vest on June 15, 2016, and the other half shall vest on December 15, 2016. The reporting person, however, must be serving in the same capacity on behalf of Premier Biomedical, Inc., as he or she was serving on the date the warrant was granted in order for any of the underlying shares to vest on the foregoing dates. Subject to the foregoing vesting schedule, the warrant may be exercised in whole or in part beginning on October 7, 2015.