X0304 4 2011-10-11 0 0001222244 ProUroCare Medical Inc. PUMD 0000901152 DAVIS JAMES L 6446 FLYING CLOUD DR EDEN PRAIRIE MN 55344 1 0 1 0 Common Stock, $0.00001 par value 94964 I Held by "Davis & Associates 401K PSP" Common Stock, $0.00001 par value 57482 I Held by "Davis & Associates Inc." Common stock, $0.00001 par value 2366748 D Warrants 5.00 2012-12-27 Common stock, $0.00001 par value 5800 5800 D Warrants 5.00 2012-12-27 Common stock, $0.00001 par value 6050 6050 I Held by "Davis & Associates Inc. 401K PSP" Warrants 5.00 2012-12-27 Common stock, $0.00001 par value 700 700 I Held by "Davis & Associates Inc." Warrants 1.50 2013-04-03 Common stock, $0.00001 par value 25000 25000 D Warrants .50 2012-12-31 Common stock, $0.00001 par value 30000 30000 D Warrants .70 2012-12-31 Common stock, $0.00001 par value 30000 30000 D Warrants .70 2012-12-31 Common stock, $0.00001 par value 10000 10000 I Held by "Davis & Associates Inc. 401K PSP" Warrants .70 2012-12-31 Common stock, $0.00001 par value 5000 5000 I Held by "Davis & Associates Inc." Warrants 1.00 2012-12-31 Common stock, $0.00001 par value 30000 30000 D Warrants 1.50 2013-09-25 Common stock, $0.00001 par value 100000 100000 D Warrants 2.00 2013-10-31 Common Stock, $0.00001 par value 16667 16667 D Warrants 1.30 2014-01-07 Common Stock, $0.00001 par value 195000 195000 D Options 2.41 2017-03-01 Common stock, $0.00001 par value 10374 10374 D Warrant 1.30 2013-07-12 Common stock, $0.00001 par value 100000 100000 D Warrant 1.30 2013-07-12 Common stock, $0.00001 par value 20000 20000 I Held by "Davis & Associates Inc. 401(k) PSP" Warrant 1.30 2013-07-12 Common stock, $0.00001 par value 20000 20000 I Held by "Davis & Associates Inc." Warrants 1.30 2013-08-02 Common stock, $0.0001 par value 286923 286923 D Warrants 1.30 2014-01-07 Common stock, $0.00001 par value 54964 54964 I Held by "Davis & Associates Inc. 401K PSP" Warrants 1.30 2013-08-02 Common stock, $0.0001 par value 20000 20000 I Held by Davis & Associates, Inc. 401(k) PSP Warrants 1.30 2014-01-07 Common stock, $0.00001 par value 17482 17482 I Held by "Davis & Associates Inc." Warrants 1.30 2013-08-02 Common stock, $0.0001 par value 20000 20000 I Held by Davis & Associates, Inc. Options 1.72 2017-08-10 Common stock, $0.00001 par value 14535 14535 D Warrants 1.30 2014-01-07 Common stock, $0.00001 par value 50000 50000 D Stock options 0.87 2018-08-09 Common stock, $0.00001 par value 28736 28736 D Convertible Note 1.30 2013-09-20 Common stock, $0.00001 par value 150000 D Convertible Note 1.10 2012-02-28 Common Stock, $0.00001 par value 11758 D Put option 2011-10-11 4 A 0 77586 A Common stock, $0.00001 par value 77586 77586 D Warrant 1.30 2012-02-08 4 G 0 1500 0 D 2014-01-07 Common stock, $0.00001 par value 77923 76423 D Currently exercisable Reporting person is the Sole owner of Davis & Associates Inc. and has sole voting power. Options vest as to 433 shares per month for 23 months beginning April 1, 2010 and as to 415 shares on March 1, 2012. On October 31, 2011, the reporting person purchased a $100,000, 10% convertible secured subordinated promissory note from the issuer in a private placement. The promissory note and any accrued interest thereon is convertible at any time at the option of the reporting person into common stock at $1.30 per share. The promissory note matures on September 20, 2013, and may be called any time after the price of the issuer's common stock exceeds $4.00 per share for 10 consecutive days. The issuer's Board of Directors specifically approved the reporting person's participation in the private placement as exempt from the requirements of Section 16b as provided by Rules 16b-3(d) and 16b-3(e). Stock options vest ratably over a 12 month period beginning August 9, 2011. On December 14, 2011, the reporting person and the Company executed a convertible promissory note in the principal amount of $1,833 with a maturity date of February 28, 2012. The principal amount and interest accruing at a rate of 10% per year are convertible into common shares at $1.10 per share at any time through the maturity date. The number of shares to be issued upon conversion will be fixed on the conversion date and reported on a Form 4 within 2 business days after conversion. The issuer's Board of Directors specifically approved the transaction as exempt from the requirements of Section 16b as provided by Rules 16b-3(d). On October 11,2011, pursuant to a loan guarantee, the Issuer agreed to issue to the Reporting Person 77,586 shares of its common stock upon the Reporting Person's request, at no cost to the Reporting Person, at any time on or before October 11, 2014. The shares have not been issued, and the Reporting Person is not entitled to vote the shares until the shares are issued. The issuer's Board of Directors specifically approved the transaction as exempt from the requirements of Section 16b as provided by Rules 16b-3(d). Richard B. Thon by power of attorney 2012-02-08