SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
VF High Conviction Fund

(Last) (First) (Middle)
31 CARRINGTON STREET

(Street)
NEDLANDS C3 6009

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/14/2016
3. Issuer Name and Ticker or Trading Symbol
UNIVERSAL BIOSENSORS INC [ UBI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock(1) 7,597,929 D(2)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. Traded as CHESS Depositary Interests ("CDIs") on the Australian Securities Exchange. CDIs represent beneficial interests in the common stock held by CHESS Depositary Nominees Pty Ltd.
2. The common stock is directly held by VF High Conviction Fund ("Conviction Fund") and indirectly held by Viburnum Funds Pty Ltd ("Viburnum"), the sole trustee and manager of Conviction Fund, and the individual directors of Viburnum (Viburnum and the individual directors together, the "Viburnum Indirect Reporting Persons"). The individual directors of Viburnum are Craig Coleman, Marshall Allen, Anthony Howarth and Melissa Karlson. The Viburnum Indirect Reporting Persons disclaim beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the Conviction Fund common stock in which the Viburnum Indirect Reporting Persons have no pecuniary interest.
Remarks:
Exhibit 24.1 - Power of Attorney
/s/ David St. Quintin, attorney-in-fact For VF High Conviction Fund and Viburnum Funds Pty Ltd 07/20/2016
** 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 5 (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.
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