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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series A Convertible Preferred Stock | (2) | (3) | (4) | Common Stock | 44,168 (2) | 4,859 (2) | I | Held by ReGen Capital II (5) | |||||||
Stock Options | $ 0.97 | (6) | 09/27/2014 | Common Stock | 80,000 | 80,000 | D | ||||||||
Director Stock Option (7) | $ 1 | 01/11/2005 | A | 11,010 | (8) | 01/11/2015 | Commn Stock | 11,010 | $ 0 | 11,010 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Herskowitz Neil 2109 BROADWAY, SUITE 206 NEW YORK, NY 10023 |
X |
/s/ Neil Herskowitz | 02/16/2005 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | A limited liability company of which the Reporting Person is a member holding 50%. |
(2) | 4,859 shares of Series A Convertible Preferred Stock, which is convertible into 44,168 shares of Common Stock without additional consideration. |
(3) | Immediately |
(4) | Does not expire. |
(5) | An entity of which the Reporting Person is a 50% owner. |
(6) | 26,667 shares vest on each of 9/27/04 and 9/27/05 and 26,666 shares vest on 9/27/06. |
(7) | Under the 2003 Stock Option Plan |
(8) | 3,670 shares vest on each of 1/11/05, 1/11/06, and 1/11/07. |