0001493152-24-000168.txt : 20240102 0001493152-24-000168.hdr.sgml : 20240102 20240102210652 ACCESSION NUMBER: 0001493152-24-000168 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231229 FILED AS OF DATE: 20240102 DATE AS OF CHANGE: 20240102 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Breithaupt John Spencer CENTRAL INDEX KEY: 0001567207 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40715 FILM NUMBER: 24504186 MAIL ADDRESS: STREET 1: 3041 W. PASADENA DR. CITY: BOISE STATE: ID ZIP: 83705 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PetVivo Holdings, Inc. CENTRAL INDEX KEY: 0001512922 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] ORGANIZATION NAME: 08 Industrial Applications and Services 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 X0508 4 2023-12-29 0 0001512922 PetVivo Holdings, Inc. PETV 0001567207 Breithaupt John Spencer 5251 EDINA INDUSTRIAL BLVD. EDINA, MN 55439 1 0 0 0 0 Stock Option (right to buy) 1.06 2023-12-29 4 A 0 30508 0 A 2030-12-28 Common Stock 30508 30508 D The Options were granted under the PetVivo Holdings, Inc. Amended and Restated 2020 Equity Incentive Plan and vest on the earlier of (i) September 30, 2024, or (ii) the day immediately preceding the next annual meeting of stockholders following the grant date, subject to the Reporting Person's continued service as a director through the vesting date. /s/ John Spencer Breithaupt 2024-01-02