Statement of Changes in Beneficial Ownership (4)
October 28 2014 - 4:53PM
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).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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
*
Fife John M.
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2. Issuer Name
and
Ticker or Trading Symbol
UNITED AMERICAN HEALTHCARE CORP
[
UAHC
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
See Remarks
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(Last)
(First)
(Middle)
303 EAST WACKER DRIVE SUITE 1200
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3. Date of Earliest Transaction
(MM/DD/YYYY)
10/28/2014
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(Street)
CHICAGO, IL 60601
(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 Stock
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10/24/2014
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10/28/2014
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J
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12750000
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A
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$.0043
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22482304
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I
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See footnote (1)
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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. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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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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Explanation of Responses:
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Remarks:
(1) The Issuer issued 12,750,000 shares of its common stock to St. George Investments, LLC, as a result of St. George's exercise of a remedy, upon the occurrence of an event of default, to receive shares of Common Stock in lieu of cash, at a price of $.004323 per share, of $55,118.25 of the outstanding balance of that certain Secured Promissory Note dated August 14, 2012, attached as Exhibit 4.2 to the Amendment to the Current Report on Form 8-K/A filed by the Issuer on August 27, 2012. John M. Fife owns a controlling interest in, and has investment control over the portfolio of, St. George. St. George also directly owns: (a) 278,936 shares of Common Stock, as disclosed in John M. Fife's Amendment No. 9 to the Schedule 13D filed on November 16, 2010 and the Statement of Changes in Beneficial Ownership on Form 4 filed by St. George on June 8, 2010; (b) 774,151 shares of Common Stock, as disclosed in the Issuer's Current Report on Form 8-K filed on June 28, 2011 and Reporting Person John M. Fife's Form 4 filed on June 29, 2011; (c) 2,010,658 shares of Common Stock, as disclosed in the Issuer's Current Report on Form 8-K filed on May 18, 2011 and Reporting Person John M. Fife's Form 4 filed on May 20, 2011 and June 29, 2011; and (d) 5,600,000 shares issued to St. George on June 25, 2013, upon the conversion by St. George of a convertible promissory note made by the Issuer in favor of St. George, as disclosed in the Schedule 13D, Amendment No. 16 filed by the reporting persons on July 8, 2013. John M. Fife also owns a controlling interest in, and has investment control over the portfolio of, Chicago Venture Partners, L.P., which directly owns 1,068,559 shares of Common Stock, as disclosed in Amendment No. 9 to the Schedule 13D filed by John M. Fife on November 16, 2010, and the Initial Statement of Beneficial Ownership of Securities on Form 3 filed by Chicago Venture Partners, L.P. on August 30, 2010.
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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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Fife John M.
303 EAST WACKER DRIVE SUITE 1200
CHICAGO, IL 60601
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X
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X
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See Remarks
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Signatures
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/s/ John M. Fife
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10/28/2014
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**
Signature of Reporting Person
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Date
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/s/ John M. Fife, authorized signatory of ST. GEORGE INVESTMENTS, LLC
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10/28/2014
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**
Signature of Reporting Person
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Date
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/s/ John M. Fife, authorized signatory for FIFE TRADING INC.
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10/28/2014
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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 4(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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