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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/19/2017 |
3. Issuer Name and Ticker or Trading Symbol
Avant Diagnostics, Inc [ AVDX ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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 | 13,283,333 | I | Through Infusion 51a, LP |
Common Stock | 4,075,000 | I | Through International Infusion, LP |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 | ||||
Senior Secured Convertible Promissory Notes | 11/16/2016 | 01/15/2018 | Common Stock | $32,500 | $0.15 | I | Through Infusion 51a, LP |
Senior Secured Convertible Promissory Notes | 12/02/2016 | 01/15/2018 | Common Stock | $19,500 | $0.15 | I | Through Infusion 51a, LP |
Senior Secured Convertible Promissory Notes | 12/06/2016 | 01/15/2018 | Common Stock | $91,000 | $0.15 | I | Through Infusion 51a, LP |
Senior Secured Convertible Promissory Notes | 12/12/2016 | 01/15/2018 | Common Stock | $65,000 | $0.15 | I | Through Infusion 51a, LP |
Senior Secured Convertible Promissory Notes | 12/13/2016 | 01/15/2018 | Common Stock | $39,000 | $0.15 | I | Through Infusion 51a, LP |
Senior Secured Convertible Promissory Notes | 11/16/2016 | 01/15/2018 | Common Stock | $39,000 | $0.15 | I | Through International Infusion, LP |
Senior Secured Convertible Promissory Notes | 12/23/2016 | 01/15/2018 | Common Stock | $195,000 | $0.15 | I | Through International Infusion, LP |
Warrants | 06/19/2017 | 06/19/2022 | Common Stock | 10,833,333(1) | $0.06 | I | Through Infusion 51a, LP |
Common Stock Purchase Rights | 01/19/2019 | 06/19/2022 | Common Stock | 43,333,333(2) | $0.06 | I | Through Infusion 51a, LP |
Senior Secured Convertible Promissory Notes | 06/19/2017 | 06/19/2020 | Common Stock | $300,000 | $0.06 | I | Through Infusion 51a, LP |
Explanation of Responses: |
1. Warrants were acquired on the same day in different transactions involving 10,000,000 and 833,333 warrants. |
2. Common Stock Purchase Rights were acquired on same day in two different transactions involving 40,000,000 Common Stock Purchase Rights and 3,333,333 Common Stock Purchase Rights. |
Scott VanderMeer | 06/28/2017 | |
** 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. |