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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
8% Convertible Promissory Note | $ 0.24 | 11/29/2018 | A | $ 54,945.05 | (1) | (2) | Common Stock | 228,937 | $ 0.24 | 228,937 | D | ||||
Warrant to Purchase Common Stock | $ 0.36 | 11/29/2018 | A | 189,466 | 05/29/2019(3) | 11/29/2023 | Common Stock | 189,466 | $ 0.36 | 189,466 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Cohen David Seth C/O PRECIPIO, INC. 4 SCIENCE PARK NEW HAVEN, CT 06511 |
X | X |
/s/ David Cohen | 12/14/2018 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(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). |
(1) | In connection with a 8% Senior Secured Convertible Promissory Note dated November 29, 2018, the holders of a majority of the aggregate principal amount of the convertible promissory notes that were issued by the registrant in the offering of which the note purchased by the reporting person is a part have the right to elect to convert the entire unpaid principal amount (and accrued interest) of such notes into the common stock of the registrant on the maturity date of such notes. |
(2) | N/A |
(3) | In connection a Common Stock Purchase Warrant Agreement dated November 29, 2018, the reporting person is may purchase one share of the issuer's common stock per one dollar invested at a price per share of $0.36. |