-----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, QSPzF0eqJ94jBgq/BMS8BM+A1T6nmczOOHjn8SEzp/7gSDRmr8aBX00pRK/EPplY /kBSC4Hxt0KZz6zB7iRr3w== 0001250853-05-000001.txt : 20050125 0001250853-05-000001.hdr.sgml : 20050125 20050125150059 ACCESSION NUMBER: 0001250853-05-000001 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041231 FILED AS OF DATE: 20050125 DATE AS OF CHANGE: 20050125 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROZGA JACEK CENTRAL INDEX KEY: 0001269764 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-32603 FILM NUMBER: 05546961 BUSINESS ADDRESS: STREET 1: 110 W GEORGE BURNS ROAD STREET 2: SUITE D 4018 CITY: LOS ANGELES STATE: CA ZIP: 90048 BUSINESS PHONE: 3104237702 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ARBIOS SYSTEMS INC CENTRAL INDEX KEY: 0001138862 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 911955323 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 8797 BEVERLY BOULEVARD STREET 2: #206 CITY: LOS ANGELES STATE: CA ZIP: 90048 BUSINESS PHONE: 310-423-7702 MAIL ADDRESS: STREET 1: 8797 BEVERLY BOULEVARD STREET 2: #206 CITY: LOS ANGELES STATE: CA ZIP: 90048 FORMER COMPANY: FORMER CONFORMED NAME: HISTORICAL AUTOGRAPHS USA INC DATE OF NAME CHANGE: 20010419 5 1 primary_doc.xml PRIMARY DOCUMENT X0202 5 2004-12-31 0 0 0 0001138862 ARBIOS SYSTEMS INC ABOS 0001269764 ROZGA JACEK 8797 BEVERLY BLVD., SUITE 206 LOS ANGELES CA 90048 1 1 1 0 CEO & President Common Stock 12/21/2004 2004-12-21 5 G 0 70000 D 2265000 D Gift of common stock of Issuer to charity. Reporting person disclaims beneficial ownership of the gifted shares. /s/ Jacek Rozga 2005-01-25 -----END PRIVACY-ENHANCED MESSAGE-----