-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, OxIbLHnw7YvWCt3C9rnuqvNU/8nLPcoPKJ+UbZf3JDoFzLVA8YttsecYSj+F6WVk FUPyuSJIxw+sfGYQH3ddzg== 0001209191-08-026522.txt : 20080430 0001209191-08-026522.hdr.sgml : 20080430 20080430163724 ACCESSION NUMBER: 0001209191-08-026522 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20071212 FILED AS OF DATE: 20080430 DATE AS OF CHANGE: 20080430 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: UNIVERSAL BIOSENSORS INC CENTRAL INDEX KEY: 0001279695 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 980424072 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 103 RICKETTS ROAD STREET 2: MT. WAVERLEY CITY: VICTORIA STATE: C3 ZIP: 3149 BUSINESS PHONE: 613-8542-9000 MAIL ADDRESS: STREET 1: 103 RICKETTS ROAD STREET 2: MT. WAVERLEY CITY: VICTORIA STATE: C3 ZIP: 3149 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CM Capital Venture Trust No. 3 CENTRAL INDEX KEY: 0001399492 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-52607 FILM NUMBER: 08790313 BUSINESS ADDRESS: STREET 1: LEVEL 4, 167 EAGLE STREET STREET 2: BRISBANE CITY: QUEENSLAND STATE: C3 ZIP: 4000 BUSINESS PHONE: 617 3221-5922 MAIL ADDRESS: STREET 1: LEVEL 4, 167 EAGLE STREET STREET 2: BRISBANE CITY: QUEENSLAND STATE: C3 ZIP: 4000 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2007-12-12 0 0001279695 UNIVERSAL BIOSENSORS INC UBI 0001399492 CM Capital Venture Trust No. 3 1 CORPORATE AVENUE ROWVILLE VICTORIA C3 3178 AUSTRALIA 0 0 1 0 Common Stock 2007-12-12 4 P 0 2597505 3117006.00 A 17794384 I CM Capital Investments Pty LTD The aggregate price of the common stock reported is stated in Australian dollars. CM Capital Investments Pty Ltd holds 14,286,272 shares of the reported securities as trustee of the CM Capital Venture Trust No. 3. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of its pecuniary interest therein. CIBC Australia VC Fund LLC holds 3,508,112 shares of the reported securities as general partner of the Australia Venture Capital Fund L.P., of which CM Capital Investments Pty Ltd is a special limited partner. The Reporting Person disclaims beneficial ownership of the reported seucrities except to the extent of its pecuniary interest therein. Exhibit List: Exhibit 24 - Power of Attorney /s/ Cameron Billingsley as Attorney in Fact 2008-04-30 EX-24.4_237582 2 poa.txt POA DOCUMENT LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS Know all persons by these presents, that the undersigned hereby constitutes and appoints each of Cameron Billingsley, Salesh Balak, and Mark Morrison, signing singly, as the undersigned's true and lawful attorney-in-fact to: (1) Execute for and on behalf of the undersigned, in the undersigned's capcacity as a beneficial owner of more than 10% of a class of Universal Biosensors Inc.'s (the "Company") equity securities, Forms 3, 4 and 5 (and any amendments thereto) in accordance with Section 16(a) of the Securities and Exchange Act of 1934 (the "Act") and the rules thereunder; (2) Do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Forms 3, 4, and 5 and timely file such Forms with the United States Securities and Exchange Commission and any stock exchange or similar authority; and (3) Take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required of, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this limited power of attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisit, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this limited power of attorney and all rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsbilities to comply with Section 16 of the Act. This limited power of attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of, and transactions in securities issued by, the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact. IN WITNESS WHEREOF, the undersigned has caused this limited power of attorney to be executed as of this 28th day of April, 2008. /s/ Andy Jane Andy Jane, authorized representative of CM Capital Investments Pty Ltd as trustee of CM Capital Venture Trust No. 3 -----END PRIVACY-ENHANCED MESSAGE-----