-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, FF3D+5hwyxImrk8edp1DMp7lvYWsKpU3CZfQzClfiShx8cyDW2anBDd5yhPDeCat MF2QSuz23Mvj1OOYkgKSeQ== 0001104659-09-046095.txt : 20090730 0001104659-09-046095.hdr.sgml : 20090730 20090730210104 ACCESSION NUMBER: 0001104659-09-046095 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090728 FILED AS OF DATE: 20090730 DATE AS OF CHANGE: 20090730 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PHARMATHENE, INC CENTRAL INDEX KEY: 0001326190 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 202726770 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE PARK PLACE, SUITE 450 CITY: ANNAPOLIS STATE: MD ZIP: 21401 BUSINESS PHONE: 410 269 2600 MAIL ADDRESS: STREET 1: ONE PARK PLACE, SUITE 450 CITY: ANNAPOLIS STATE: MD ZIP: 21401 FORMER COMPANY: FORMER CONFORMED NAME: HEALTHCARE ACQUISITION CORP DATE OF NAME CHANGE: 20050505 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SCHAFFER DERACE L CENTRAL INDEX KEY: 0001031735 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32587 FILM NUMBER: 09975155 MAIL ADDRESS: STREET 1: C/O ALLION HEALTHCARE, INC. STREET 2: 1660 WALT WHITMAN ROAD, SUITE 105 CITY: MELVILLE STATE: NY ZIP: 11747 4 1 a4.xml 4 X0303 4 2009-07-28 0 0001326190 PHARMATHENE, INC PIP 0001031735 SCHAFFER DERACE L C/O PHARMATHENE, INC. ONE PARK PLACE, SUITE 450 ANNAPOLIS MD 21401 1 0 0 0 10% Unsecured Convertible Note 2.5417 2009-07-28 4 A 0 1000000.00 A 2009-07-28 2011-07-28 Common Stock 393442 1000000.00 D Common Stock Warrant 2.50 2009-07-28 4 A 0 133333 A 2010-01-28 2015-01-28 Common Stock 133333 133333 D This Note and Warrant were received in an exempt transaction pursuant to a Note and Warrant Purchase Agreement dated as of July 24, 2009, as amended as of July 26, 2009 and July 28, 2009, by and among the Issuer and certain investors (the "Agreement"). Pursuant to the Agreement, the Reporting Person received a 10% Unsecured Convertible Note in the principal amount of $1,000,000.00 (conversion price of $2.541667 per share) and a warrant to purchase 133,333 shares of Common Stock at a purchase price of $2.50 per share. /s/ Roland S. Chase, attorney in fact 2009-07-30 -----END PRIVACY-ENHANCED MESSAGE-----