Statement of Changes in Beneficial Ownership (4)
June 07 2018 - 5:00PM
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
*
Chowdhury Dewan Fazlul Hoque
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2. Issuer Name
and
Ticker or Trading Symbol
Nemaura Medical Inc.
[
NMRD
]
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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)
Chief Executive Officer
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(Last)
(First)
(Middle)
ADVANCED TECHNOLOGY INNOVATION CENTRE, 5 OAKWOOD DRIVE
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3. Date of Earliest Transaction
(MM/DD/YYYY)
6/5/2018
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(Street)
LOUGHBOROUGH LEICESTERSHIRE, X0 LE11 3QF
(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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6/5/2018
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J
(1)
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87537000
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A
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$0.00
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87537000
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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. 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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Series A Convertible Preferred Stock
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$0.00
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6/5/2018
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C
(1)
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87.537
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(2)
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(3)
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Common Stock, par value $0.01
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87537000
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$0.00
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0
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D
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Explanation of Responses:
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(1)
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The Reporting Person converted all of his shares of Series A Convertible Preferred Stock into Common Stock, whereby each share of Series A Convertible Preferred was converted into 1,000 shares of Common Stock.
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(2)
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The Reporting Person can automatically convert after all of the following events occur:(a) the sugarBEAT(R) device to be commercialized has CE regulatory approval; (b) retail sales have commenced; and (c) retail sales exceed USD$5 million, which includes any advanced sales (the "Triggering Events"); the disinterested members of the Board shall confirm the satisfaction of all Triggering Events by written notice to the Corporation's transfer agent. The Reporting Person can voluntarily convert any shares of Series A Preferred then outstanding into fully paid and nonassessable shares of Common Stock.
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(3)
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The conversion rights do not expire.
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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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Chowdhury Dewan Fazlul Hoque
ADVANCED TECHNOLOGY INNOVATION CENTRE
5 OAKWOOD DRIVE
LOUGHBOROUGH LEICESTERSHIRE, X0 LE11 3QF
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X
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X
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Chief Executive Officer
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Signatures
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/s/ Dewan Fazlul Hoque Chowdhury
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6/7/2018
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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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