0001493152-24-000170.txt : 20240102 0001493152-24-000170.hdr.sgml : 20240102 20240102210655 ACCESSION NUMBER: 0001493152-24-000170 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: Jasper Joseph William CENTRAL INDEX KEY: 0001753636 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40715 FILM NUMBER: 24504187 MAIL ADDRESS: STREET 1: 201 SOUTH 11TH STREET STREET 2: UNIT 1030 CITY: MINNEAPOLIS STATE: MN ZIP: 55403 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 0001753636 Jasper Joseph William 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 31780 0 A 2030-12-28 Common Stock 31780 31780 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/ Joseph Jasper 2024-01-02