0001493152-21-024487.txt : 20211004
0001493152-21-024487.hdr.sgml : 20211004
20211004152506
ACCESSION NUMBER: 0001493152-21-024487
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211001
FILED AS OF DATE: 20211004
DATE AS OF CHANGE: 20211004
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: 001-40715
FILM NUMBER: 211302348
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
2021-10-01
0
0001512922
PetVivo Holdings, Inc.
PETV
0001403679
Rudelius Robert James
5251 EDINA INDUSTRIAL BLVD
EDINA,
MN
55439
1
0
0
0
Common Stock
2021-10-01
4
A
0
8333
0.00
A
189997
D
These shares will vest and be issued with respect to 4,167 shares on October 1, 2021 and 4,166 shares will vest on March 31, 2022, pursuant to restricted stock units granted to the Reporting Person for Board services pursuant to the PetVivo Holdings, Inc. 2020 Equity Incentive Plan ("2020 Plan").
Includes 8,333 shares that will be issued over time subject to vesting pursuant to the restricted stock units granted under the 2020 Plan.
/s/ ROBERT RUDELIUS
2021-10-04