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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Convertible Promissory Note | $ 0.67 | 07/19/2007 | 07/19/2007 | C | 3,546,118 | (6) | 01/23/2011 | Common Stock | 3,546,118 | $ 0.67 | 2,611,940 | I | see footnote (1) | ||
Convertible Promissory Note | $ 2.19 | (6) | (7) | Common Stock | 228,310 | 228,310 | I | see footnote (2) | |||||||
Employee Stock Options | $ 0.28 | 07/27/2007 | A | 1,000,000 | 07/27/2007 | 07/27/2017 | Common Stock | 1,000,000 | $ 0 | 2,800,000 | D (5) | ||||
Stock Purchase Warrants | $ 2.49 | (6) | 05/26/2008 | Common Stock | 500,000 | 500,000 | I | see footnote (2) | |||||||
Stock Purchase Warrants | $ 0.67 | (6) | 01/23/2011 | Common Stock | 1,198,630 | 1,198,630 | I | see footnote (2) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
WEINER MICHAEL L 3349 MONROE AVE UNIT 350 ROCHESTER, NY 14618 |
X | President |
/s/ Michael L. Weiner | 09/17/2007 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | On July19, 2007, Biomed converted $2,180,000 of Convertible Promissory Notes into 3,253,731 shares of Biophan common stock at a conversion price of $0.67. In addition, accrued interest of $195,899 was converted into 292,387 shares. |
(2) | Held held by Biomed Solutions, LLC ("Biomed"), of which the reporting person is the Manager. Biomed is 57% owned by Technology Innovations, LLC ("TI"), of which the reporting person is a member and the Manager. The reporting person disclaims beneficial ownership of the issuer's securities held by Biomed except to the extent of his indirect ownership interest in Biomed through TI. |
(3) | Held by TI. The reporting person disclaims beneficial ownership of the issuer's securities held by TI except to the extent of his ownership interest in TI. |
(4) | Held by Myotech, LLC ("Myotech"), of which the reporting person is a director. The reporting person disclaims beneficial ownership of the issuer's securities held by Myotech except to the extent of his pecuniary interest in Myotech. |
(5) | The reporting person holds various options to purchase common stock granted under the Issuer's employee stock option plans. The options are exercisable at prices ranging from $0.18 to $0.97 per share and expire on various dates ranging from 1/1/11 to 7/27/17. |
(6) | Convertible or exercisible at option of holder. |
(7) | Payable on demand. |