Amended Statement of Beneficial Ownership (3/a)
May 07 2020 - 6:41PM
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
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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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Witherill Michael J |
2. Date of Event Requiring Statement (MM/DD/YYYY)
3/26/2020
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3. Issuer Name and Ticker or Trading Symbol
Bio-Matrix Scientific Group, Inc. [BMSN]
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(Last)
(First)
(Middle)
1206 E WARNER ROAD, SUITE 101-B |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
__X__ Director ___X___ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) Vice Chairman and President / |
(Street)
GILBERT, AZ 85296
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY) 4/17/2020
| 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 Beneficially Owned
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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 | 2182117 (1) | I | By Debbie Rasmussen |
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) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 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) |
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
(1) | These shares are held by Mr. Witherill's wife, Debbie Rasmussen. Mr. Witherill disclaims beneficial ownership of the 2,182,117 shares owned by Ms. Rasmussen, and this report cannot be deemed an admission that Mr. Witherill is the beneficial owner of those securities for purposes of Section 16 or for any other purpose. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Witherill Michael J 1206 E WARNER ROAD SUITE 101-B GILBERT, AZ 85296 | X | X | Vice Chairman and President |
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Signatures
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/s/ Michael J Witherill | | 5/7/2020 |
**Signature of Reporting Person | Date |