0001104659-23-100218.txt : 20230913 0001104659-23-100218.hdr.sgml : 20230913 20230913063401 ACCESSION NUMBER: 0001104659-23-100218 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230911 FILED AS OF DATE: 20230913 DATE AS OF CHANGE: 20230913 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Coleman Craig E. CENTRAL INDEX KEY: 0001678533 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-52607 FILM NUMBER: 231251577 MAIL ADDRESS: STREET 1: 1 CORPORATE AVENUE CITY: ROWVILLLE VICTORIA STATE: C3 ZIP: 3178 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: 1 CORPORATE AVENUE STREET 2: ROWVILLE CITY: VICTORIA STATE: C3 ZIP: 3178 BUSINESS PHONE: 613-9213-9000 MAIL ADDRESS: STREET 1: 1 CORPORATE AVENUE STREET 2: ROWVILLE CITY: VICTORIA STATE: C3 ZIP: 3178 4 1 tm2326055-1_4seq1.xml OWNERSHIP DOCUMENT X0508 4 2023-09-11 0 0001279695 UNIVERSAL BIOSENSORS INC UBI 0001678533 Coleman Craig E. 1 CORPORATE AVENUE VICTORIA C3 3178 AUSTRALIA 1 0 1 0 0 Common Stock 2023-09-11 4 P 0 100000 0.220 A 753620 I By the Coleman Super Fund Common Stock 55798601 I By Partnership Stock Option (Right to Buy - Exercise Price $0.20) 1000000 I By Partnership Stock Option (Right to Buy - Exercise Price $0.92) 1920000 I By Partnership Stock Option (Right to Buy - Exercise Price $1.00) 1920000 I By Partnership Traded as Chess Depository Interests ("CDIs") on the Australian Stock Exchange. CDIs represent beneficial interests in the common stock held by CHESS Depository Nominees Pty Ltd. The price reported is stated in Australian dollars. The Reporting Person is a director of Viburnum, which is the manager of each of VF Strategic Equities Fund ("Strategic Fund") and separately managed accounts on behalf of a Viburnum client ("Strategic Mandates") the direct beneficial owners of the common stock and stock options. The Reporting Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of the common stock and stock options held by Strategic Fund, and Strategic Mandates, except to the extent of his pecuniary interest therein. Viburnum, as the manager of Strategic Fund and Strategic Mandates, may be deemed to beneficially own 55,798,601 shares of common stock, which consists of 22,169,559 and 33,629,042 shares of common stock held by Strategic Fund and Strategic Mandates, respectively. Viburnum, as the manager of each of Strategic Fund and Strategic Mandates, shares voting and dispositive power over, and may be deemed to beneficially own, the common stock held by the foregoing entities. The Reporting Person shares voting and dispositive power over, and may be deemed to beneficially own, the common stock held by the foregoing entities due to the Reporting Person serving as a director of Viburnum. Craig E. and Phylis Coleman are the trustees of the Coleman Super Fund, of which Mr. Coleman is a potential beneficiary. Viburnum, as the manager of Strategic Fund may be deemed to beneficially own 1,000,000 stock options which an exercise price of A$0.20 and expiry date of 03/24/2024. Viburnum, as the manager of Strategic Fund and Strategic Mandates, may be deemed to beneficially own 1,920,000 stock options which an exercise price of A$0.92 and expiry date of 05/26/2025. Viburnum, as the manager of Strategic Fund and Strategic Mandates, may be deemed to beneficially own 1,920,000 stock options which an exercise price of A$1.00 and expiry date of 05/26/2025. /s/ David St. Quintin, as attorney-in-fact 2023-09-13