0001144204-17-009464.txt : 20170216 0001144204-17-009464.hdr.sgml : 20170216 20170216065259 ACCESSION NUMBER: 0001144204-17-009464 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170214 FILED AS OF DATE: 20170216 DATE AS OF CHANGE: 20170216 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 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: 17616420 MAIL ADDRESS: STREET 1: 1 CORPORATE AVENUE CITY: ROWVILLLE VICTORIA STATE: C3 ZIP: 3178 4 1 v459813_form4.xml OWNERSHIP DOCUMENT X0306 4 2017-02-14 0 0001279695 UNIVERSAL BIOSENSORS INC UBI 0001678533 Coleman Craig E. 1 CORPORATE AVENUE VICTORIA C3 3178 AUSTRALIA 1 0 1 0 Common Stock 2017-02-14 4 P 0 7782 0.34 A 27280538 I By Partnership Common Stock 220000 I By the Coleman Super Fund 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 in Column 4 is a weighted average price. These shares were sold in multiple transactions all at a price of $0.34. The Reporting Person undertakes to provide to Universal Biosensors, Inc. ("UBI"), any security holder of UBI, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote (2) to this Form 4. The price per share of the common stock reported is stated in Australian dollars, as converted from a U.S. dollar price on the date of the transaction. The Reporting Person is a director of Viburnum Funds Pty Ltd ("Viburnum"), which is the manager of each of VF Strategic Equities Fund ("Strategic Fund") and VF High Conviction Fund ("Conviction Fund"), the direct beneficial owners of the common stock. 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 held by Strategic Fund and Conviction Fund, except to the extent of his pecuniary interest therein. Viburnum, as the manager of Strategic Fund and Conviction Fund, may be deemed to beneficially own 27,280,538 shares of common stock, which consists of 17,420,000 and 9,860,538 shares of common stock held by Strategic Fund and Conviction Fund, respectively. Viburnum, as the manager of each of Strategic Fund and Conviction Fund, 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. /s/ David St. Quintin, as attorney-in-fact 2017-02-16