FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Medytox Solutions, Inc. [ MMMS ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 02/05/2013 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 02/05/2013 | 02/05/2013 | G | V | 4,500,000(1) | D | $0 | 0 | I | By Alcimede LLC(1) |
Common Stock | 02/05/2013 | 02/05/2013 | G | V | 4,500,000(1) | A | $0 | 4,500,000 | I | By Epizon Ltd.(1) |
Common Stock | 02/08/2013 | 02/08/2013 | J(2) | V | 4,500,000 | D | $0 | 0 | I | See note(2) |
Common Stock | 12/31/2013 | 12/31/2013 | G | V | 1,300,000 | D | $0 | 0 | D(3) | |
Restricted Stock | 03/13/2014 | 03/13/2014 | A | 30,000(4) | A | $0 | 30,000 | I | By Alcimede, LLC(4) | |
Series B Non-Convertible Preferred Stock | 02/05/2013 | 02/05/2013 | G | V | 1,000(5) | A | $0 | 1,000 | I | By Epizon Ltd.(5) |
Series B Non-Convertible Preferred Stock | 02/05/2013 | 02/05/2013 | G | V | 1,000(5) | D | $0 | 0 | I | By Alcimede, LLC(5) |
Series B Non-Convertible Preferred Stock | 02/08/2013 | 02/08/2013 | J(2) | V | 1,000 | D | $0 | 0 | I | See note(2) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. On February 5, 2013, 4,500,000 shares of the Issuer's Common Stock owned of record by Alcimede LLC were distributed to Epizon Ltd. Seamus Lagan was the then sole owner of Epizon Ltd., and disclaims beneficial ownership of the reported securities, except to the extent of his pecuniary interest therein. |
2. On February 8, 2013, Seamus Lagan distributed all of the capital stock of Epizon Ltd. to The Shanoven Trust. P. Wilhelm F. Toothe is the trustee of The Shanoven Trust. Mr. Lagan is the settlor and Mr. Lagan and his family are the beneficiaries of The Shanoven Trust. As a consequence of the distribution of all of the capital stock of Epizon Ltd. to The Shanoven Trust, Mr. Lagan is no longer a beneficial owner of the Issuer's Common Stock and the Issuer's Series B Non-Convertible Preferred Stock owned of record by Epizon Ltd. pursuant to Section 16(a) of the Securities Exchange Act of 1934. |
3. On December 31, 2013, Seamus Lagan distributed 1,300,000 shares of the Issuer's Common Stock to Epizon Ltd. |
4. The grant of the restricted stock of the Issuer vests in full on September 13, 2014, subject to the continued engagement of Alcimede LLC by the Issuer. |
5. The 1,000 shares of the Issuer's Series B Non-Convertible Preferred Stock owned of record by Alcimede LLC, were distributed to Epizon Ltd. on February 5, 2013. On February 5, 2013, Seamus Lagan was the sole owner of Epizon Ltd., and disclaims beneficial ownership of the reported securities, except to the extent of his pecuniary interest therein. |
/s/ Seamus Lagan | 03/31/2015 | |
Alcimede LLC By /s/ Seamus Lagen, sole member | 03/31/2015 | |
** 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 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). | ||
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. |