SEC Form 4 · accession 0001176485-18-000001
Sanara MedTech Inc. · SMTI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James W Stuckert
Director · 10% Owner
Period of report
Feb 19, 2018
Accepted (ET)
Jun 5, 2018 · 7:01 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000714256
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F4 | Feb 19, 2018 | J | 11,325,678 | $0.07 | A | 22,057,433 | I | By James W. Stuckert Revocable Trust |
| Common StockF2,F4 | Feb 19, 2018 | J | 13,037,070 | $0.07 | A | 65,094,503 | I | By James W. Stuckert Revocable Trust |
| Common StockF3,F5 | Feb 19, 2018 | J | 3,965,400 | $0.07 | A | 5,365,400 | I | By Diane V. Stuckert Revocable Trust |
| Common StockF6 | holding | — | — | — | 1,500,000 | I | By James W. Stuckert Family Trust | |
| Common StockF7 | holding | — | — | — | 835,586 | I | Ten Grand Ltd. |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series C Preferred StockF2,F4 | — | Feb 19, 2018 | J | 36,384 | D | Feb 10, 2016 | — | Common Stock | 43,037,070 | 0 | I |
| Series C Preferred StockF3,F5 | — | Feb 19, 2018 | J | 3,572 | D | Dec 21, 2015 | — | Common Stock | 3,965,400 | 0 | I |
Explanation of responses
- F1On February 19, 2018, the James W. Stuckert Revocable Trust converted all principal and interest under that certain promissory note, dated as of June 15, 2015, in the principal amount of $600,000, into 11,325,678 shares of the Company's Common Stock.
- F2On February 19, 2018, the James W. Stuckert Revocable Trust converted 36,384 shares of the Company's Series C Convertible Preferred Stock, together with all accrued but unpaid dividends thereon, into a total of 43,037,070 shares of the Company's Common Stock.
- F3On February 19, 2018, the Diane V. Stuckert Revocable Trust converted 3,572 shares of the Company's Series C Convertible Preferred Stock, together with all accrued but unpaid dividends thereon, into a total of 3,965,400 shares of the Company's Common Stock.
- F4The reporting person is the trustee of the trust.
- F5The reporting person's spouse is trustee of the trust. The reporting person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
- F6The reporting person's spouse is trustee of the trust. The reporting person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
- F7The reporting person serves as the general partner of the partnership.