Statement of Changes in Beneficial Ownership (4)
February 28 2020 - 4:04PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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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
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Atwood Brent |
2. Issuer Name and Ticker or Trading Symbol
AngioSoma, Inc.
[
SOAN
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
5000 RIVERSIDE DRIVE, STE 100E, BLDG. 6 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
2/25/2020 |
(Street)
IRVING, TX 75039
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Shares | 2/25/2020 | | D | | 2750000 | D | $0.001 | 0 | I | Equine Charter Private Equity Fund VII, LLC (1) |
Common Shares | 2/25/2020 | | D | | 2282400 | D | $0.002 | 0 | I | Equine Charter Private Equity Fund XI (1) |
Common Shares | 2/25/2020 | | D | | 6927500 | D | $0.001 | 0 | I | Equine Charter Private Equity Fund XX (1) |
Common Shares | 2/25/2020 | | D | | 7447200 | D | $0.001 | 0 | I | Equine Holdings Charter Private Equity Fund XIII 13 (1) |
Common Shares | 2/25/2020 | | D | | 6000000 | D | $0.001 | 0 | I | Equine Private Equity Fund 755460, LLC (1) |
Common Shares | 2/25/2020 | | D | | 2000000 | D | $0.002 | 0 | I | Equine Charter Private Equity Fund XII (1) |
Common Shares | 2/25/2020 | | D | | 50000 | D | $0.001 | 0 | I | Goddard Investment Company PE Fund XIX (1) |
Common Shares | 2/25/2020 | | D | | 250000 | D | $0.001 | 0 | I | Equine Private Equity Fund LXXVII (77) LLC (1) |
Common Shares | 2/25/2020 | | D | | 1650000 | D | $0.001 | 0 | I | Equine Charter Private Equity Fund DCCCLXXXVIII, LLC (1) |
Common Shares | 2/25/2020 | | D | | 2148604 | D | $0.001 | 0 | I | Equine Charter Private Equity Fund XV |
Common Shares | 2/25/2020 | | D | | 170000 | D | $0.001 | 0 | I | Family Trust |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security (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) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
(1) | Brent Atwood is the Chief Executive Manager of Equine Holdings, LLC ("Holdings") and each of the following entities: Equine Charter Private Equity Fund VII, LLC, Equine Charter Private Equity Fund XII, Equine Charter Private Equity Fund XI, Equine Charter Private Equity Fund XX, Goddard Investment Company PE Fund XIX, Equine Private Equity Fund LXXVII (77) LLC, Equine Holdings Charter Private Equity Fund XIII 13, Equine Charter Private Equity Fund XV, LLC, Equine Charter Private Equity Fund DCCCLXXXVIII, LLC and Equine Private Equity Fund 755460, LLC (the "Equine Entities"). Holdings also serves as the manager of, and holds a 1% interest in each of the Equine Entities. Mr. Atwood and Holdings each disclaim beneficial ownership of the reported securities except to the extent of their pecuniary interest therein. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Atwood Brent 5000 RIVERSIDE DRIVE STE 100E, BLDG. 6 IRVING, TX 75039 |
| X |
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Signatures
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/s/ Brent Atwood | | 2/28/2020 |
**Signature of Reporting Person | Date |