0001556244-19-000112.txt : 20191206 0001556244-19-000112.hdr.sgml : 20191206 20191206184329 ACCESSION NUMBER: 0001556244-19-000112 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191205 FILED AS OF DATE: 20191206 DATE AS OF CHANGE: 20191206 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Carroll Khristine L CENTRAL INDEX KEY: 0001672352 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11737 FILM NUMBER: 191274032 MAIL ADDRESS: STREET 1: 229 ANDOVER STREET CITY: WILMINGTON STATE: MA ZIP: 01887 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AdvanSource Biomaterials Corp CENTRAL INDEX KEY: 0001011060 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 043186647 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 229 ANDOVER STREET CITY: WILMINGTON STATE: MA ZIP: 01887 BUSINESS PHONE: 978-657-0075 MAIL ADDRESS: STREET 1: 229 ANDOVER STREET CITY: WILMINGTON STATE: MA ZIP: 01887 FORMER COMPANY: FORMER CONFORMED NAME: CARDIOTECH INTERNATIONAL INC DATE OF NAME CHANGE: 19960321 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2019-12-05 0 0001011060 AdvanSource Biomaterials Corp ASNB 0001672352 Carroll Khristine L 229 ANDOVER STREET WILMINGTON MA 01887 0 1 0 0 SVP Common Stock 2019-12-05 4 X 0 100000 0.06 A 385309 D Common Stock 2019-12-05 4 X 0 350000 0 A 735309 D Common Stock 2019-12-05 4 X 0 600000 0 A 1335309 D Shares acquired through the exercise of options granted pursuant to the 2003 Stock Option Plan at an exercise price of $0.06 per share in consideration of cash. Shares acquired from the exercise of options pursuant to the 2017 Non-Qualified Equity Incentive Plan (the "2017 Plan") which provided for the exercise of options into 500,000 shares of the Company's common stock at an exercise price of $0.06 per share which were exercised on a cashless basis, as provided for in the 2017 Plan, resulting in the issuance of 350,000 shares, net. Shares acquired from the exercise of options granted pursuant to the 2017 Non-Qualified Equity Incentive Plan (the "2017 Plan") which provided for the exercise of options into 750,000 shares of the Company's common stock at an exercise price of $0.04 per share which were exercised on a cashless basis, as provided for in the 2017 Plan, resulting in the issuance of 600,000 shares, net. /s/ Khristine Carroll 2019-12-06