Initial Statement of Beneficial Ownership (3)
June 21 2016 - 4:29PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
0.5
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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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1. Name and Address of Reporting Person
*
Welch Thomas Patrick
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2. Date of Event Requiring Statement (MM/DD/YYYY)
6/17/2016
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3. Issuer Name
and
Ticker or Trading Symbol
BioCorRx Inc. [BICX]
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(Last)
(First)
(Middle)
10453 SARAH ST.
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
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X
___ Officer (give title below)
_____ Other (specify below)
Vice President of Operations /
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(Street)
TOLUCA LAKE, CA 91602
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
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X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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2584939
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Stock Option
(1)
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6/17/2016
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6/17/2026
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Common Stock
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11200000
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$0.0201
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D
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Explanation of Responses:
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(
1)
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Mr. Welch was the Company's Director of Operations from February 26, 2015 through June 16, 2016. In this position, Mr. Welch was a consultant to the Company and performed services for other companies. Mr. Welch was not in charge of a principal business unit, division or function and did not have a policy-making function with the Company. On June 17, 2016, Mr. Welch and the Company entered into an Executive Service Agreement pursuant to which he was appointed the Company's Vice President of Operations. Mr. Welch is now a full-time executive of the Company, is in charge of the Company's operations function, and has a policy-making function.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Welch Thomas Patrick
10453 SARAH ST.
TOLUCA LAKE, CA 91602
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Vice President of Operations
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Signatures
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/s/ Thomas Welch
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6/21/2016
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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