SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
Shah Ameet

(Last) (First) (Middle)
545 FIFTH AVENUE
SUITE 1109

(Street)
NEW YORK NY 10017

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/22/2008
3. Issuer Name and Ticker or Trading Symbol
Assured Pharmacy, Inc. [ APHY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
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 3,493,731 I By managed accounts(1)
Common Stock 2,500,000 I By Mosaic Financial Services, LLC(1)
Common Stock 448,083 I To be issued to managed accounts(1)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: 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
Warrants to Purchase Common Stock 04/12/2006 04/12/2009 Common Stock 512,500 $0.6 I By managed account(1)
Warrants to Purchase Common Stock 10/18/2005 10/18/2008 Common Stock 375,000 $0.6 I By managed account(1)
Warrants to Purchase Common Stock 04/12/2006 04/12/2009 Common Stock 625,000 $0.6 I By managed account(1)
Warrants to Purchase Common Stock 06/08/2006 06/08/2009 Common Stock 112,500 $0.6 I By managed account(1)
Warrants to Purchase Common Stock 11/17/2007 11/17/2009 Common Stock 666,875 $0.6 I By managed accounts(1)
Warrants to Purchase Common Stock 11/23/2007 11/23/2008 Common Stock 625,000 $0.6 I By managed accounts(1)
Warrants to Purchase Common Stock 12/07/2007 12/07/2008 Common Stock 312,500 $0.6 I By managed accounts(1)
Warrants to Purchase Common Stock 12/13/2007 12/13/2008 Common Stock 250,000 $0.6 I By managed accounts(1)
Warrants to Purchase Common Stock 01/29/2008 01/29/2009 Common Stock 62,500 $0.6 I By managed accounts(1)
Warrants to Purchase Common Stock 02/11/2008 02/11/2009 Common Stock 250,000 $0.6 I By managed accounts(1)
Warrants to Purchase Common Stock 11/17/2007 11/17/2010 Common Stock 666,875 $0.8 I By managed accounts(1)
Warrants to Purchase Common Stock 11/23/2007 11/23/2009 Common Stock 625,000 $0.8 I By managed accounts(1)
Warrants to Purchase Common Stock 12/07/2007 12/07/2009 Common Stock 312,500 $0.8 I By managed accounts(1)
Warrants to Purchase Common Stock 12/13/2007 12/13/2009 Common Stock 250,000 $0.8 I By managed accounts(1)
Warrants to Purchase Common Stock 01/29/2008 01/29/2010 Common Stock 62,500 $0.8 I By managed accounts(1)
Warrants to Purchase Common Stock 02/11/2008 02/11/2010 Common Stock 250,000 $0.8 I By managed accounts(1)
Convertible Debentures 11/17/2007 03/31/2008 Common Stock 1,333,750 $0.4 I By managed account(1)
Convertible Debentures 11/23/2007 03/31/2008 Common Stock 1,250,000 $0.4 I By managed account(1)
Convertible Debentures 12/07/2007 03/31/2008 Common Stock 625,000 $0.4 I By managed account(1)
Convertible Debentures 12/13/2007 03/31/2008 Common Stock 500,000 $0.4 I By managed account(1)
Convertible Debentures 01/29/2008 03/31/2008 Common Stock 125,000 $0.4 I By managed account(1)
Convertible Debentures 02/11/2008 03/31/2008 Common Stock 500,000 $0.4 I By managed account(1)
Explanation of Responses:
1. The reporting person disclaims beneficial ownership of these shares except to an extent of the reporting person's pecuring interest in the shares.
/s/ Ameet Shah 03/24/2008
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.