UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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. | SEC 1473 (7-02) | ||
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. |
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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
CHURCHILL WINSTON J 490 LAPP ROAD MALVERN, PA 19355 |
 X |  |  |  |
/s/ Donna Nichols, attorney-in-fact | 11/03/2016 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | On March 13, 2014, the reporting person filed a Form 3 mistakenly reporting indirect beneficial ownership of 1,120,120 shares of common stock based on the conversion of Series A Redeemable Convertible Preferred Stock and 2,043,053 shares of common stock based on the conversion of all principal and accrued interest on 8% Convertible Promissory Notes, each held by partnerships. As of March 6, 2014, the reporting person did not have indirect beneficial ownership of such shares, which were owned by SCP Vitalife Partners (Israel) II, L.P. and SCP Vitalife Partners II L.P. As of March 6, 2014, the reporting person beneficially owned no securities of the issuer. |