SEC FORM 4

SEC Form 4

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^*

Spafford David

(Last)

(First)

(Middle)

C/O GREAT BASIN SCIENTIFIC, INC.

2441 SOUTH 3850 WEST

(Street)

SALT LAKE CITY

84120

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
Great Basin Scientific, Inc. [ GBSN ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
10/15/2014

4. 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 Acquired, Disposed of, or Beneficially Owned
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)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock	10/15/2014		C		101,653	A	⁽¹⁾	148,403	I	By Spring Forth Investments, LLC
Common Stock	10/15/2014		C		27,407	A	⁽¹⁾	28,650	I	By SBS Charitable Remainder Trust U/A/D November 27, 1995
Common Stock	10/15/2014		C		5,662	A	⁽¹⁾	5,918	I	By DRS Charitable Remainder Trust U/A/D May 5, 1993
Common Stock	10/15/2014		C		28,597	A	⁽¹⁾	177,000	I	By Spring Forth Investments, LLC
Common Stock	10/15/2014		C		63,047	A	⁽¹⁾	63,047	I	By Bourne Spafford Charitable Trust U/A/D May 15, 1995
Common Stock	10/15/2014		C		186,014	A	⁽¹⁾	191,932	I	By DRS Charitable Remainder Trust U/A/D May 5, 1993
Common Stock	10/15/2014		C		42,182	A	⁽¹⁾	105,229	I	By Bourne Spafford Charitable Trust U/A/D May 15, 1995
Common Stock	10/15/2014		C		420,135	A	⁽¹⁾	448,785	I	By SBS Charitable Remainder Trust U/A/D November 27, 1995
Common Stock	10/15/2014		C		180,000	A	⁽¹⁾	357,000	I	By Spring Forth Investments, LLC
Common Stock	10/15/2014		C		20,622	A	⁽¹⁾	23,122	I	By DRS, LLC
Common Stock Warrants	10/15/2014		C		11,158	A	⁽²⁾	11,158	D

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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)
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)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Series A Convertible Preferred Stock	⁽¹⁾	10/15/2014		C			101,653	⁽¹⁾	⁽¹⁾	Common Stock	101,653	$0.0	0	I	By Spring Forth Investments, LLC
Series A Convertible Preferred Stock	⁽¹⁾	10/15/2014		C			27,407	⁽¹⁾	⁽¹⁾	Common Stock	27,407	$0.0	0	I	By SBS Charitable Remainder Trust U/A/D November 27, 1995
Series A Convertible Preferred Stock	⁽¹⁾	10/15/2014		C			5,662	⁽¹⁾	⁽¹⁾	Common Stock	5,662	$0.0	0	I	By DRS Charitable Remainder Trust U/A/D May 5, 1993
Series B Convertible Preferred Stock	⁽¹⁾	10/15/2014		C			28,597	⁽¹⁾	⁽¹⁾	Common Stock	28,597	$0.0	0	I	By Spring Forth Investments, LLC
Series B Convertible Preferred Stock	⁽¹⁾	10/15/2014		C			63,047	⁽¹⁾	⁽¹⁾	Common Stock	63,047	$0.0	0	I	By Bourne Spafford Charitable Trust U/A/D May 15, 1995
Series C Convertible Preferred Stock	⁽¹⁾	10/15/2014		C			186,014	⁽¹⁾	⁽¹⁾	Common Stock	186,014	$0.0	0	I	By DRS Charitable Remainder Trust U/A/D May 5, 1993
Series C Convertible Preferred Stock	⁽¹⁾	10/15/2014		C			42,182	⁽¹⁾	⁽¹⁾	Common Stock	42,182	$0.0	0	I	By Bourne Spafford Charitable Trust U/A/D May 15, 1995
Series C-1 Convertible Preferred Stock	⁽¹⁾	10/15/2014		C			420,135	⁽¹⁾	⁽¹⁾	Common Stock	420,135	$0.0	0	I	By SBS Charitable Remainder Trust U/A/D November 27, 1995
Series D Convertible Preferred Stock	⁽¹⁾	10/15/2014		C			180,000	⁽¹⁾	⁽¹⁾	Common Stock	180,000	$0.0	0	I	By Spring Forth Investments, LLC
Series D Convertible Preferred Stock	⁽¹⁾	10/15/2014		C			20,622	⁽¹⁾	⁽¹⁾	Common Stock	20,622	$0.0	0	I	By DRS, LLC
Series A Convertible Preferred Stock Warrants	⁽¹⁾	10/15/2014		C			11,158	⁽¹⁾	⁽¹⁾	Coimmon Stock	11,158	$0.0	0	D

Explanation of Responses:

1. The Series A Convertible Preferred Stock, Series B Convertible Preferred Stock, Series C Convertible Preferred Stock, Series C-1 Convertible Preferred Stock and Series D Convertible Preferred Stock were converted into an equal number of shares of Common Stock and had no expiration date.

2. The Series A Convertible Preferred Stock Warrants were converted into an equal number of Common Stock Warrants, with the same expiration date as previously disclosed.

Remarks:

	/s/ Jeffrey Rona, Attorney-in-Fact	10/17/2014
	** 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).
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