1. Name and Address of Reporting Person * |
Patel Kinnary |
|
2. Date of Event Requiring Statement (Month/Day/Year) 09/24/2020 |
3. Issuer Name and Ticker or Trading Symbol Greenwich LifeSciences, Inc. [GLSI]
|
C/O GREENWICH LIFESCIENCES, INC., 3992 BLUEBONNET DR, BUILDING 14 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director |
__X__ 10% Owner |
_____ Officer (give title below) |
_____ Other (specify below) |
|
|
5. If Amendment, Date Original Filed(Month/Day/Year)
|
STAFFORD, TX 77477 |
6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
|
Table I - Non-Derivative Securities Beneficially Owned |
|
1.Title of Security (Instr. 4) |
2. Amount of Securities Beneficially Owned (Instr. 4) |
3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) |
4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common stock
|
2,405,670
|
I
|
See footnote
(1)
|
Common stock
|
1,320,226
|
I
|
See footnote
(2)
|
Common stock
|
1,329,590
|
I
|
See footnote
(3)
|
|
* |
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) |
The securities are owned by Patel Family Trust 1. Kinnary Patel, as co-Trustee of Patel Family Trust 1, shares voting and dispositive power over the securities held by such trust with her spouse. |
(2) |
The securities are owned by Patel Family Trust 2. Kinnary Patel, as co-Trustee of Patel Family Trust 2, shares voting and dispositive power over the securities held by such trust with her spouse. |
(3) |
The securities are owned by Patel Family Trust 3. Kinnary Patel, as co-Trustee of Patel Family Trust 3, shares voting and dispositive power over the securities held by such trust with her spouse. |
(4) |
The Series B Preferred Stock have no expiration date and are convertible, at the option of the holder, into shares of common stock of the Issuer at the then-effective conversion rate for no additional consideration (subject to the payment of cash, if applicable, in lieu of any fractional shares in accordance with the Issuer's Amended and Restated Certificate of Incorporation (as amended, the "Certificate of Incorporation")). |
(5) |
The Series B Preferred Stock is convertible into shares of the Issuer's common stock at a 1-for-1 conversion rate. |
(6) |
Kinnary Patel is the Trustee of the Kinnary Patel IRA and in such capacity has the right to vote and dispose of the securities held by such IRA. |
(7) |
The Series D Preferred Stock have no expiration date and are convertible, at the option of the holder, into shares of common stock of the Issuer at the then-effective conversion rate for no additional consideration (subject to the payment of cash, if applicable, in lieu of any fractional shares in accordance with the Certificate of Incorporation). |
(8) |
The Series D Preferred Stock is convertible into shares of the Issuer's common stock at a 1-for-1 conversion rate. |