0000721748-13-000116.txt : 20130513
0000721748-13-000116.hdr.sgml : 20130513
20130513152717
ACCESSION NUMBER: 0000721748-13-000116
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120101
FILED AS OF DATE: 20130513
DATE AS OF CHANGE: 20130513
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Shlomo Sam Elimelech
CENTRAL INDEX KEY: 0001328099
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-51216
FILM NUMBER: 13837070
MAIL ADDRESS:
STREET 1: FARM #389
CITY: BNAYA
STATE: L3
ZIP: 76858
FORMER NAME:
FORMER CONFORMED NAME: Elimelech Shlomo Sam
DATE OF NAME CHANGE: 20050523
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ANDAIN, INC.
CENTRAL INDEX KEY: 0001321502
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 202066406
STATE OF INCORPORATION: NV
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 350 S. CENTER STREET
STREET 2: SUITE 500
CITY: RENO
STATE: NV
ZIP: 89501
BUSINESS PHONE: 775-333-5997
MAIL ADDRESS:
STREET 1: 350 S. CENTER STREET
STREET 2: SUITE 500
CITY: RENO
STATE: NV
ZIP: 89501
4
1
f4_elimelech.xml
OWNERSHIP DOCUMENT
X0306
4
2012-01-01
0
0001321502
ANDAIN, INC.
ANDNE
0001328099
Shlomo Sam Elimelech
FARM #389
BNAYA
L3
76858
ISRAEL
1
1
1
0
President
Common Stock
2012-01-01
4
D
0
2720000
0.001
D
4525878
D
Common Stock
2012-09-20
4
P
0
18000000
0.001
A
22525878
D
Mr. Elimelech returned to the Company?s treasury effective on January 1, 2012 2,720,000 shares of common stock from the because of a reclassification of the value of the 4,000,000 shares of common stock issued by the Company under a Regulation S Stock Purchase Agreement between Mr. Elimelech and the Company, dated January 5, 2011.
On July 29, 2012, the Company entered into a Regulation S Stock Purchase Agreement with Sam Shlomo Elimelech, the Company?s president and a director. Under this agreement, Mr. Elimelech purchased from the Company 18,000,000 restricted shares of common stock at $0.001 per share, for a total consideration of $18,000. These shares were actually issued on September 20, 2012.
In computing the number of shares beneficially owned by this stockholder, shares of common stock subject to options or convertible or exchangeable into such shares of common stock held by that person that are currently exercisable, or exercisable within 60 days, are included. Therefore, 660,000 of the total consists of shares of common stock underlying the vested and exercisable (as of January 1, 2013) portion of a stock option for 990,000 shares of common stock granted by the Company in exchange for services rendered to the Company.
50,000 shares of common stock are owned indirectly by Mr. Elimelech in accordance with Rule 13d-3 under the1934 Act (they are held by members of Mr. Elimelech?s household).
Sam Shlomo Elimelech
2013-05-10