0001493152-23-030010.txt : 20230823 0001493152-23-030010.hdr.sgml : 20230823 20230823194305 ACCESSION NUMBER: 0001493152-23-030010 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230819 FILED AS OF DATE: 20230823 DATE AS OF CHANGE: 20230823 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jasper Joseph William CENTRAL INDEX KEY: 0001753636 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40715 FILM NUMBER: 231198663 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] 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 2023-08-19 0 0001512922 PetVivo Holdings, Inc. PETV 0001753636 Jasper Joseph William 5251 EDINA INDUSTRIAL BLVD EDINA, MN 55439 1 0 0 0 0 Common Stock 2023-08-19 4 F 0 12212 1.33 A 34754 D Common Stock 2000 I By wife Common Stock Warrant 1.33 2023-08-19 4 M 0 22500 0 D 2020-06-30 2023-08-20 Common Stock 22500 0 D Represents a cashless exercise of outstanding warrants to purchase 22,500 shares of common stock. The Reporting Person received 12,212 shares of common stock and surrendered 10,288 shares of common stock underlying the warrants. /s/ Joseph Jasper 2023-08-23