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*
PETERSON JEFFREY S

(Last) (First) (Middle)
539 BLACKHAWK LANE

(Street)
ALPINE UT 84004

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
ACTIVECARE, INC. [ ACAR ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
CFO
3. Date of Earliest Transaction (Month/Day/Year)
09/23/2015
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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 09/23/2015 J(1) 6,000,000 A (1) 12,632,288 I By Tyumen Holdings, LLC
Common Stock 09/23/2015 A 48,100 A (2) 12,680,388 I By Tyumen Holdings, LLC(2)
Common Stock 09/23/2015 A 2,000,000 A (3)(5) 4,759,277 I By Bluestone Advisors, LLC(3)
Common Stock 09/23/2015 A 201,056 A $0.27(4) 4,960,333 I By Bluestone Advisors, LLC(4)
Common Stock 09/23/2015 A 359,375 A (6) 5,319,708 I By Bluestone Advisors, LLC(6)
Common Stock 378,148 I By Keystone Partners, LLC
Common Stock 295,139 I By RimRock Capital
Common Stock 2,862,966 I By Wynnman's Hill, LLC
Common Stock 20,270 I By Banyan Investment Company, LLC
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
1. Name and Address of Reporting Person*
PETERSON JEFFREY S

(Last) (First) (Middle)
539 BLACKHAWK LANE

(Street)
ALPINE UT 84004

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
X Officer (give title below) Other (specify below)
CFO
1. Name and Address of Reporting Person*
Tyumen Holdings, LLC

(Last) (First) (Middle)
539 BLACKHAWK LANE

(Street)
ALPINE UT 84004

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. The shares of common stock were granted in consideration of an agreement by certain of the Reporting Person's affiliated entities to extend the terms of certain loan obligations of the issuer to such entities; however, at the request of the Reporting Person, the shares were issued to Tyumen Holdings, LLC.
2. The shares of common stock were issued to pay dividends on shares of Series D Preferred Stock which were originally issued as compensation for services provided by Jeff Peterson; however, at Mr. Peterson's request, the shares of Series D Preferred Stock were issued in the name of Tyumen Holdings, LLC.
3. The shares of common stock were granted as a stock bonus to Jeff Peterson; however, at Mr. Peterson's request, the shares were issued in the name of Bluestone Advisors, LLC.
4. The shares of common stock were granted to pay accrued compensation for services rendered by Jeff Peterson; however, at Mr. Peterson's request, such shares were issued in the name of Bluestone Advisors, LLC.
5. The shares vest in 24 equal monthly installments.
6. The shares of common stock were granted in consideration of Jeff Peterson's agreement to guarantee certain loan obligations of the issuer; however, at the request of Mr. Peterson, the shares were issued to Bluestone Advisors, LLC.
Jeffrey Peterson 01/11/2016
Jeffrey Peterson, Manager 01/11/2016
** 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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