SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Patel Kinnary

(Last) (First) (Middle)
C/O GREENWICH LIFESCIENCES, INC.
3992 BLUEBONNET DR, BUILDING 14

(Street)
STAFFORD TX 77477

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/24/2020
3. Issuer Name and Ticker or Trading Symbol
Greenwich LifeSciences, Inc. [ GLSI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common stock 2,405,670 I See footnote(1)
Common stock 1,320,226 I See footnote(2)
Common stock 1,329,590 I See footnote(3)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Series B Preferred Stock (4) (4) Common stock 76,780 (5) I See footnote(6)
Series D Preferred Stock (7) (7) Common stock 45,328 (8) I See footnote(6)
Explanation of Responses:
1. The securities are owned by Patel Family Trust 1. Kinnary Patel, as co-Trustee of Patel Family Trust 1, shares voting and dispositive power over the securities held by such trust with her spouse.
2. The securities are owned by Patel Family Trust 2. Kinnary Patel, as co-Trustee of Patel Family Trust 2, shares voting and dispositive power over the securities held by such trust with her spouse.
3. The securities are owned by Patel Family Trust 3. Kinnary Patel, as co-Trustee of Patel Family Trust 3, shares voting and dispositive power over the securities held by such trust with her spouse.
4. The Series B Preferred Stock have no expiration date and are convertible, at the option of the holder, into shares of common stock of the Issuer at the then-effective conversion rate for no additional consideration (subject to the payment of cash, if applicable, in lieu of any fractional shares in accordance with the Issuer's Amended and Restated Certificate of Incorporation (as amended, the "Certificate of Incorporation")).
5. The Series B Preferred Stock is convertible into shares of the Issuer's common stock at a 1-for-1 conversion rate.
6. Kinnary Patel is the Trustee of the Kinnary Patel IRA and in such capacity has the right to vote and dispose of the securities held by such IRA.
7. The Series D Preferred Stock have no expiration date and are convertible, at the option of the holder, into shares of common stock of the Issuer at the then-effective conversion rate for no additional consideration (subject to the payment of cash, if applicable, in lieu of any fractional shares in accordance with the Certificate of Incorporation).
8. The Series D Preferred Stock is convertible into shares of the Issuer's common stock at a 1-for-1 conversion rate.
/s/ Kinnary Patel 10/09/2020
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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