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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
ACTIVECARE, INC. [ ACAR ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 11/18/2011 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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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 | 11/18/2011 | P | 22,500 | A | $3.91 | 144,168 | D | |||
Common Stock | 04/01/2013 | A | 2,299(1) | A | $1(3) | 146,467(1) | D | |||
Common Stock | 06/24/2013 | A | 9,000(1) | A | $1(7) | 155,467(1) | D | |||
Common Stock | 09/30/2013 | A | 3,562(1) | A | (2) | 159,029(1) | D | |||
Common Stock | 12/16/2013 | A | 36,000(1) | A | $1(7) | 195,029(1) | D | |||
Common Stock | 12/16/2013 | A | 462(1) | A | $1(3) | 195,491(1) | D | |||
Common Stock | 12/16/2013 | A | 324,100(4) | A | $0.71(4) | 519,591(1) | D | |||
Common Stock | 12/31/2013 | A | 3,922(1) | A | (2) | 523,513(1) | D | |||
Common Stock | 01/13/2014 | P | 34,001 | A | $1 | 557,514 | D | |||
Common Stock | 01/27/2014 | A | 3,000(1) | A | $1(7) | 560,514(1) | D | |||
Common Stock | 03/31/2014 | A | 6,700(1) | A | $1(7) | 567,214(1) | D | |||
Common Stock | 05/22/2014 | A | 300,000 | A | $1(3) | 867,214(1) | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 | ||||||||
Series D Convertible Preferred Stock | (5) | 09/30/2013 | A | 22,000 | (5) | (5) | Common Stock | 110,000 | (5) | 46,300 | D | ||||
Series D Convertible Preferred Stock | (4)(6) | 12/16/2013 | D(4) | 46,300 | (6) | (6) | Common Stock | 324,100(6) | (4)(6) | 0 | D |
Explanation of Responses: |
1. On May 16, 2013, issuer effected a reverse stock split of its outstanding common stock at an exchange ratio of 1-for-10. The stated number of shares of common stock have been adjusted to reflect such reverse stock split. |
2. The shares of common stock were granted to pay dividends on Series D Preferred Stock. |
3. The shares of common stock were granted to pay accrued salary. |
4. The Reporting Person received 324,100 shares of common stock in exchange for 46,300 shares of Series D Preferred Stock in an issuer exchange offer. |
5. On September 30, 2013, the Board of Directors of issuer granted the shares to the Reporting Person in lieu of payment of compensation owing to the Reporting Person. The shares vested at the time of the grant, and were convertible at any time, at the holder's election, on a five-for-one basis and had no expiration date. |
6. As a result of the reverse stock split effected by issuer on May 16, 2013, the conversion ratio for previously issued Series D Preferred Stock was adjusted to five-for-one, and all Series D Preferred Stock issued following the effective date of the reverse stock split also had a conversion ratio of five-for-one; however, under the terms of the issuer exchange offer, the Reporting Person was entitled to exchange each share of Series D Preferred Stock for seven shares of common stock. All of the subject shares of Series D Preferred Stock vested at the time of grant, were convertible at any time, and had no expiration date. |
7. The shares of common stock were granted to pay origination fees to the Reporting Person for amounts loaned by the Reporting Person to issuer. |
Michael G. Acton | 12/01/2014 | |
** 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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |