- Statement of Changes in Beneficial Ownership (4)
June 15 2010 - 9:53PM
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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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public
Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Rudelius Robert James
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2. Issuer Name
and
Ticker or Trading Symbol
ProUroCare Medical Inc.
[
PUMD
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
1525 LINCOLN CRICLE, APT 401
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3. Date of Earliest Transaction
(MM/DD/YYYY)
6/11/2010
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(Street)
MCCLEAN, VA 22101
(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, $0.00001 par value
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24756
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I
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Held by Noble Ventures, of which reporting person is the majority owner.
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Common stock, $0.00001 par value
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64317
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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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Stock options
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$2.9
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(2)
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6/12/2014
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Common stock, $0.00001 par value
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3000
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3000
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D
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Stock options
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$1.0
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(2)
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8/12/2015
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Common stock, $0.00001 par value
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1000
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1000
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D
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Stock options
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$0.5
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(2)
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12/31/2012
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Common stock, $0.00001 par value
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4000
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4000
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D
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Stock options
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$0.5
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(2)
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12/31/2012
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Common stock, $0.00001 par value
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2000
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2000
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I
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Held by Noble Ventures, of which reporting person is the majority owner.
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Stock options
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$1.3
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(2)
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1/7/2014
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Common stock, $0.00001 par value
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19986
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19986
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D
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Stock options
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$1.3
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(2)
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1/7/2014
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Common stock, $0.00001 par value
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4756
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4756
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I
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Held by Noble Ventures, of which reporting person is the majority owner.
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Stock options
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$0.85
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(2)
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3/3/2016
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Common stock, $0.00001 par value
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20000
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20000
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D
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Stock options
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$1.25
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(2)
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8/11/2016
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Common stock, $0.00001 par value
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1000
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1000
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D
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Stock options
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$1.50
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(3)
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9/29/2016
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Common stock, $0.00001 par value
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30000
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30000
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D
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Warrants
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$1.3
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(2)
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11/12/2012
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Common stock, $0.00001 par value
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10000
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10000
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D
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Warrants
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$1.3
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(2)
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11/12/2012
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Common stock, $0.00001 par value
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10000
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10000
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I
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Held by Noble Ventures, of which reporting person is the majority owner.
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Warrants
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$1.3
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6/11/2010
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J
(1)
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0
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7/11/2010
(1)
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7/11/2013
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Common stock, $0.00001 par value
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0
(1)
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$0
(1)
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0
(1)
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I
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Held by Noble Ventures, of which reporting person is the majority owner.
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Promissory Note
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$1
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6/11/2010
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J
(1)
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13000
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(1)
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7/11/2010
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Cash
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13000
(1)
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$0
(1)
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13000
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I
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Held by Noble Ventures, of which reporting person is the majority owner.
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Warrants
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$1.3
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6/11/2010
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J
(1)
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0
(1)
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7/11/2010
(1)
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7/11/2013
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Common stock, $0.00001 par value
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0
(1)
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$0
(1)
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0
(1)
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D
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Promissory Note
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$1
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6/11/2010
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J
(1)
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13000
(1)
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(1)
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7/11/2013
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Cash
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13000
(1)
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$0
(1)
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13000
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D
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Explanation of Responses:
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(
1)
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On June 11, 2010, the Company executed a promissory note in the principal amount of $13,000 with a maturity date of December
1, 2010, with interest to accrue daily and payable in Warrants through July 10, 2010. (the "Note"). Warrants will accrue at
a rate of 333.333 shares of common stock per day up to a maximum warrant coverage of 10,000 shares of common stock per
$13,000 original principal amount of Notes, which equals a maximum warrant of 10,000 shares of common stock with respect to
the Note. After 30 days, the Note will bear interest payable in cash and Warrants representing the accrued interest will be
issued at an exercise price of $1.30.
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(
2)
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Currently exercisable.
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(
3)
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Options shall vest on the latter of the date that the Company is cleared by the FDA to sell the ProUroScan system in the
United States or the date the Company closes on an aggregate of $2,000,000 or more of incremental equity financing after the
date of grant (including the exercise of existing warrants).
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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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Rudelius Robert James
1525 LINCOLN CRICLE
APT 401
MCCLEAN, VA 22101
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X
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Signatures
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Richard Thon as Power of Attorney
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6/15/2010
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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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