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