SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
DAVIS JAMES L

(Last) (First) (Middle)
6446 FLYING CLOUD DR

(Street)
EDEN PRAIRIE MN 55344

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
ProUroCare Medical Inc. [ PUMD ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
12/03/2012
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock, $0.00001 par value 57,482 I Held by "Davis & Associates Inc."(2)
Common stock, $0.00001 par value 2,666,139 D
Common Stock, $0.00001 par value 12/03/2012 M 75,000 A $0.5 169,964 I Held by "Davis & Associate 401K PSP"(2)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Warrants $5 (1) 12/27/2012 Common stock, $0.00001 par value 5,800 5,800 D
Warrants $5 (1) 12/27/2012 Common stock, $0.00001 par value 6,050 6,050 I Held by "Davis & Associates Inc. 401K PSP"(2)
Warrants $5 (1) 12/27/2012 Common stock, $0.00001 par value 700 700 I Held by "Davis & Associates Inc."(2)
Warrants $1.5 (1) 04/03/2013 Common stock, $0.00001 par value 25,000 25,000 D
Warrants $1 (1) 12/31/2012 Common stock, $0.00001 par value 30,000 30,000 D
Warrants $2 (1) 10/31/2013 Common Stock, $0.00001 par value 16,667 16,667 D
Warrants $1.5 (1) 09/25/2013 Common stock, $0.00001 par value 100,000 100,000 D
Warrants $1.3 (1) 01/07/2014 Common Stock, $0.00001 par value 195,000 195,000 D
Options $2.41 (1) 03/01/2017 Common stock, $0.00001 par value 10,374 10,374 D
Warrant $1.3 (1) 07/12/2013 Common stock, $0.00001 par value 100,000 100,000 D
Warrant $1.3 (1) 07/12/2013 Common stock, $0.00001 par value 20,000 20,000 I Held by "Davis & Associates Inc. 401(k) PSP"(2)
Warrant $1.3 (1) 07/12/2013 Common stock, $0.00001 par value 20,000 20,000 I Held by "Davis & Associates Inc."(2)
Warrants $1.3 (1) 08/02/2013 Common stock, $0.0001 par value 286,923 286,923 D
Warrants $1.3 (1) 01/07/2014 Common stock, $0.00001 par value 54,964 54,964 I Held by "Davis & Associates Inc. 401K PSP"(2)
Warrants $1.3 (1) 08/02/2013 Common stock, $0.0001 par value 20,000 20,000 I Held by Davis & Associates, Inc. 401(k) PSP(2)
Warrants $1.3 (1) 01/07/2014 Common stock, $0.00001 par value 17,482 17,482 I Held by "Davis & Associates Inc."(2)
Warrants $1.3 (1) 08/02/2013 Common stock, $0.0001 par value 20,000 20,000 I Held by Davis & Associates, Inc.(2)
Options $1.72 (1) 08/10/2017 Common stock, $0.00001 par value 14,535 14,535 D
Warrants $1.3 (1) 01/07/2014 Common stock, $0.00001 par value 50,000 50,000 D
Stock options $0.87 (1) 08/09/2018 Common stock, $0.00001 par value 28,736 28,736 D
Convertible Note(3) $1.3 (1) 09/20/2013 Common stock, $0.00001 par value (5) $150,000 D
Convertible Note $1.1 (1) 08/28/2012(5) Common Stock, $0.00001 par value (5) $11,758 D
Warrant $1.3 (1) 01/07/2014 Common stock, $0.00001 par value 62,923 62,923 D
Convertible Note $1.3 (1)(6) 09/20/2013 Common stock, $0.00001 par value 76,923 250,000 D
Stock Options $0.6 (4) 08/09/2019 Common stock, $0.00001 par value 25,000 25,000 D
Warrants $0.5(8) 12/03/2012 M 30,000 (1) 12/31/2012 Common stock, $0.00001 par value 30,000 $0 0 I(7) Held by "Davis & Associates 401K PSP"(2)
Warrants $0.5(8) 12/03/2012 M 10,000 (1) 12/31/2012 Common stock, $0.00001 par value 10,000 $0 0 I Held by "Davis & Associates Inc. 401K PSP"(2)
Warrants $0.5(8) 12/03/2012 M 5,000 (1) 12/31/2012 Common stock, $0.00001 par value 5,000 $0 0 I Held by "Davis & Associates 401K PSP"(2)
Warrants $0.5 12/03/2012 M 30,000 (1) 12/31/2012 Common stock, $0.00001 par value 30,000 $0 0 I(7) Held by "Davis & Associates 401K PSP"(2)(7)
Explanation of Responses:
1. Currently exercisable
2. Reporting person is the Sole owner of Davis & Associates Inc. and has sole voting power.
3. On October 31, 2011, the reporting person purchased a $100,000, 10% convertible secured subordinated promissory note from the issuer in a private placement. The promissory note and any accrued interest thereon is convertible at any time at the option of the reporting person into common stock at $1.30 per share. The promissory note matures on September 20, 2013, and may be called any time after the price of the issuer's common stock exceeds $4.00 per share for 10 consecutive days. The number of shares to be issued upon conversion will be fixed on the conversion date and reported on a Form 4 within 2 business days after conversion. The issuer's Board of Directors specifically approved the reporting person's participation in the private placement as exempt from the requirements of Section 16b as provided by Rules 16b-3(d) and 16b-3(e).
4. Annual option award pursuant to the Issuer's compensation policy for Directors upon their re-election to the Board of Directors. The seven-year options vest ratably over 12 months.
5. The principal amount and interest thereon accruing at a rate of 10% per year are convertible into common shares at $1.10 per share at any time through the August 28, 2012 maturity date. The number of shares to be issued upon conversion will be fixed on the conversion date and reported on a Form 4 within 2 business days after conversion. The issuer's Board of Directors specifically approved the transaction as exempt from the requirements of Section 16b as provided by Rules 16b-3(d).
6. On March 30, 2012, the reporting person purchased a $100,000, 10% convertible secured subordinated promissory note from the issuer in a private placement. The promissory note and any accrued interest thereon is convertible at any time at the option of the reporting person into common stock at $1.30 per share. The promissory note matures on March 31, 2014, and may be called any time after the price of the issuer's common stock exceeds $4.00 per share for 10 consecutive days. The issuer's Board of Directors specifically approved the reporting person's participation in the private placement as exempt from the requirements of Section 16b as provided by Rules 16b-3(d) and 16b-3(e).
7. Previously reported as a direct holding.
8. The exercise price had previously been reported as $0.70 per share in error. The correct exercise price is $0.50 per share, which was amended on a Form 4/A filed concurrently with this Form 4.
Remarks:
Deb - how does this look?
Richard B. Thon by power of attorney 12/05/2012
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
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