0001493152-18-018080.txt : 20181228
0001493152-18-018080.hdr.sgml : 20181228
20181228171649
ACCESSION NUMBER: 0001493152-18-018080
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181228
FILED AS OF DATE: 20181228
DATE AS OF CHANGE: 20181228
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Rudelius Robert James
CENTRAL INDEX KEY: 0001403679
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55167
FILM NUMBER: 181258049
MAIL ADDRESS:
STREET 1: 6913 ARBOR LANE
CITY: MCCLEAN
STATE: VA
ZIP: 22101
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: PetVivo Holdings, Inc.
CENTRAL INDEX KEY: 0001512922
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 990363559
STATE OF INCORPORATION: NV
FISCAL YEAR END: 0331
BUSINESS ADDRESS:
STREET 1: 5251 EDINA INDUSTRIAL BLVD
CITY: EDINA
STATE: MN
ZIP: 55439
BUSINESS PHONE: (952) 217-4952
MAIL ADDRESS:
STREET 1: 5251 EDINA INDUSTRIAL BLVD
CITY: EDINA
STATE: MN
ZIP: 55439
FORMER COMPANY:
FORMER CONFORMED NAME: Technologies Scan Corp
DATE OF NAME CHANGE: 20110211
4
1
ownership.xml
X0306
4
2018-12-28
0
0001512922
PetVivo Holdings, Inc.
PETV
0001403679
Rudelius Robert James
5251 EDINA INDUSTRIAL BLVD
EDINA
MN
55439
1
0
0
0
Common Stock
2018-12-10
4
X
0
45000
.30
A
226727
D
Common Stock
2018-12-10
4
X
0
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.30
A
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D
Common Stock
2018-12-10
4
J
0
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.30
A
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D
Common Stock
2018-12-11
4
O
0
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A
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D
Common Stock
2018-12-11
4
J
0
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.30
A
291727
D
Common Stock
2018-12-11
4
J
0
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51722
A
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D
Common Stock
2018-12-11
4
O
0
25861
.30
A
489994
D
Common Stock
2018-12-11
4
J
0
8621
.30
A
498615
D
Common Stock Warrant
.30
2018-12-10
4
X
0
45000
.30
D
2017-12-07
2020-12-07
Common Stock
45000
125000
D
Common Stock Warrant
.30
2018-12-10
4
X
0
12500
D
2018-08-20
2023-08-20
Common Stock
12500
112500
D
Common Stock Warrant
.30
2018-12-11
4
O
0
25000
50000
D
2018-09-24
2021-09-24
Common Stock
25000
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D
Common Stock Warrant
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2018-12-11
4
A
0
25861
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A
2018-12-11
2018-12-31
Common Stock
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Common Stock Warrant
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2018-12-11
4
O
0
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D
2018-12-11
2018-12-31
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D
100,000 warrants were granted to Robert Rudelius on August 20, 2018 pursuant to his Director Agreement; these warrants vest quarterly over a two-year period in equal tranches of 12,500, have a term of 5 years, and a strike price of $1.00 per warrant. Mr. Rudelius exercised 12,500 warrants that he was granted pursuant to his Director Agreement.
These warrants were exercised pursuant to a special, one-time Discounted Warrant Exercise Agreement whereby all warrant-holders were given the option to exercise their warrants at $.30 per warrant on or before December 15th, 2018.
A Stock Transfer Agreement was entered into between John Lai and Robert Rudelius pursuant to entering into the Discounted Warrant Exercise Agreement mentioned in note 2 above and called for the transfer of common stock shares from John Lai to Robert Rudelius in the amount of one-third the amount of warrants exercised pursuant to the Discounted Warrant Exercise Agreement; 19,167 shares were transferred to Robert Rudelius from John Lai pursuant to this agreement
Pursuant to a Bridge Promissory Note Conversion Agreement, Mr. Rudelius converted $51,721.86 in debt owed to him into 172,406 shares of common stock at a rate of $.30 per share.
Pursuant to a Bridge Promissory Note Conversion Agreement, Mr. Rudelius received, and subsequently exercised, 1 warrant for every $2 of the outstanding balance of his Note. The warrants had a strike price of $.30 per warrant, vested immediately, and an expiration date of December 31, 2018.
Pursuant to a Bridge Promissory Note Conversion Agreement, Mr. Rudelius entered into a Stock Transfer Agreement whereby he received 8,621 shares of common stock from John Lai; this number was calculated using a 3-to-1 warrant to share issuance rate (1 share was transferred for every 3 warrants exercised).
A Stock Transfer Agreement was entered into between John Lai and Robert Rudelius pursuant to entering into the Discounted Warrant Exercise Agreement mentioned in note 2 above and called for the transfer of common stock shares from John Lai to Robert Rudelius in the amount of one-third the amount of warrants exercised pursuant to the Discounted Warrant Exercise Agreement; 8,333 shares were transferred to Robert Rudelius from John Lai pursuant to this agreement.
/s/ Robert Rudelius
2018-12-28