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