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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 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 | ||||||||
Series B Preferred Stock | (5) | 09/29/2020 | M | 76,780 | (5) | (5) | Common Stock | 76,780 | $ 0 | 0 | I | see footnote (1) | |||
Series D Preferred Stock | (6) | 09/29/2020 | M | 45,328 | (6) | (6) | Common Stock | 45,328 | $ 0 | 0 | I | see footnote (1) | |||
Series D Preferred Stock | (7) | 09/29/2020 | J(8) | 7,292 | (7) | (7) | Common Stock | 7,292 | $ 0 | 7,292 | I | see footnote (1) | |||
Series D Preferred Stock | (6) | 09/29/2020 | M | 7,292 | (6) | (6) | Common Stock | 7,292 | $ 0 | 0 | I | see footnote (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Patel Kinnary C/O GREENWICH LIFESCIENCES, INC. 3992 BLUEBONNET DR., BUILDING 14 STAFFORD, TX 77477 |
X |
/s/ Kinnary Patel | 10/09/2020 | |
**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) | 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. |
(2) | 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. |
(3) | 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. |
(4) | 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. |
(5) | The Series B Preferred Stock converted into Issuer common stock on a 1-for-1 basis and had no expiration date. |
(6) | The Series D Preferred Stock converted into Issuer common stock on a 1-for-1 basis and had no expiration date. |
(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 Issuer's Amended and Restated Certificate of Incorporation, as amended (the "Certificate of Incorporation"). |
(8) | The Reporting Person was issued additional shares of Series D Preferred Stock in connection with the Issuer's initial public offering as a result of the anti-dilution protection provisions set forth in the Issuer's Certificate of Incorporation. |