0000905148-18-000456.txt : 20180419
0000905148-18-000456.hdr.sgml : 20180419
20180419162240
ACCESSION NUMBER: 0000905148-18-000456
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180417
FILED AS OF DATE: 20180419
DATE AS OF CHANGE: 20180419
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Schuler Henri George
CENTRAL INDEX KEY: 0001629151
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34810
FILM NUMBER: 18764014
MAIL ADDRESS:
STREET 1: 100 N. FIELD DRIVE
STREET 2: SUITE 360
CITY: LAKE FOREST
STATE: IL
ZIP: 60045
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: VERMILLION, INC.
CENTRAL INDEX KEY: 0000926617
STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835]
IRS NUMBER: 330595156
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 12117 BEE CAVES ROAD BUILDING THREE
STREET 2: SUITE 100
CITY: AUSTIN
STATE: TX
ZIP: 78738
BUSINESS PHONE: 512-519-0400
MAIL ADDRESS:
STREET 1: 12117 BEE CAVES ROAD BUILDING THREE
STREET 2: SUITE 100
CITY: AUSTIN
STATE: TX
ZIP: 78738
FORMER COMPANY:
FORMER CONFORMED NAME: CIPHERGEN BIOSYSTEMS INC
DATE OF NAME CHANGE: 20000316
FORMER COMPANY:
FORMER CONFORMED NAME: ABIOTIC SYSTEMS
DATE OF NAME CHANGE: 19950407
4
1
form4.xml
X0306
4
2018-04-17
0000926617
VERMILLION, INC.
VRML
0001629151
Schuler Henri George
100 N. FIELD DRIVE
SUITE 360
LAKE FOREST
IL
60045
true
Common Stock, par value $0.001
2018-04-17
4
P
0
654136
1
A
3551157
I
By Tanya Eva Schuler Trust
Common Stock, par value $0.001
2018-04-17
4
P
0
654136
1
A
3551157
I
By Therese Heidi Schuler Trust
Common Stock, par value $0.001
2018-04-17
4
P
0
145365
1
A
985368
I
By Schuler GC 2010 Continuation Trust
Common Stock, par value $0.001
2018-04-17
4
P
0
654137
1
A
1007377
I
By Schuler Grandchildren LLC
Common Stock, par value $0.001
141304
I
By Seascape Partners L.P.
Common Stock, par value $0.001
26000
I
By spouse
Series B Convertible Preferred Stock (Right to Buy)
2018-04-17
4
P
0
2459
100
A
Common Stock
245900
2459
I
By Tanya Eva Schuler Trust
Series B Convertible Preferred Stock (Right to Buy)
2018-04-17
4
P
0
2458
100
A
Common Stock
245800
2458
I
By Therese Heidi Schuler Trust
Series B Convertible Preferred Stock (Right to Buy)
2018-04-17
4
P
0
547
100
A
Common Stock
54700
547
I
By Schuler GC 2010 Continuation Trust
Series B Convertible Preferred Stock (Right to Buy)
2018-04-17
4
P
0
2458
100
A
Common Stock
245800
2458
I
By Schuler Grandchildren LLC
These shares of Common Stock ("Shares") and Series B Convertible Preferred Stock ("Preferred Stock") are directly owned by the Tanya Eva Schuler Trust. H. George Schuler is the sole trustee of the Tanya Eva Schuler Trust.
These Shares and Preferred Stock are directly owned by the Therese Heidi Schuler Trust. H. George Schuler is the sole trustee of the Therese Heidi Schuler Trust.
These Shares and Preferred Stock are directly owned by the Schuler GC 2010 Continuation Trust. H. George Schuler is the sole trustee of the Schuler GC 2010 Continuation Trust.
These Shares and Preferred Stock are directly owned by the Schuler Grandchildren LLC. H. George Schuler is the manager of the Schuler Grandchildren LLC.
These Shares are directly owned by Seascape Partners L.P., a family limited partnership. H. George Schuler is the manager of Seascape Partners L.P.
The reporting person disclaims beneficial ownership of these Shares and Preferred Stock except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that he is the beneficial owner of the Shares for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose.
Each share of Preferred Stock is initially convertible into 100 Shares automatically upon the Requisite Stockholder Approval (defined and described further in the Schedule 13D/A filed by the Reporting Person on April 19, 2018), subject to customary anti-dilution adjustments, reflecting an initial conversion price equal to $1.00 per share. The Preferred Stock has no expiration date.
/s/ H. George Schuler
2018-04-19