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
Modular Medical, Inc. [ MODD ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 12/31/2020 | ||||||||||||||||||||||||||
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, par value $0.001 per share | 12/31/2020 | S/K | V | 7,220,400(1) | D | (2) | 7,523,456 | I | See Footnote(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 |
Explanation of Responses: |
1. Pursuant to a Stock Transfer, Assignment and Voting Agreement dated December 30,2020 (the "Stock Transfer Agreement"), by and among the Reporting Person, Paul DiPerna Irrevocable Trust, a trust organized under the laws of California (the "Irrevocable Trust"), Paul DiPerna Trust, a trust organized under the laws of California (the "Trust"), Kelsie Nicole DiPerna ("Ms. K. DiPerna"), and Alaria Michele DiPerna ("Ms. A. DiPerna"), the Reporting Person transferred and assigned 7,220,400 shares of Common Stock to the transferees thereunder, but retained all voting rights and shared disposition rights with respect to such Common Stock. |
2. In accordance with Instruction 4 to this Form, column 7 reflects the transfer and assignment pursuant to the Stock Transfer Agreement from the Reporting Person as follows: 6,000,000 shares of Common Stock to the Irrevocable Trust, in which the Reporting Person is the trustee; 220,400 shares of Common Stock to the Trust, in which the Reporting Person is the trustee; 500,000 shares of Common Stock to Ms. K. DiPerna, the Reporting Person's daughter and 500,000 shares of Common Stock to Ms. A. DiPerna, the Reporting Person's daughter. The transferees paid only nominal amounts for their shares of Common Stock. Prior to the transactions effected pursuant to the Stock Transfer Agreement, the Trust held 303,030 shares of Common Stock. |
Remarks: |
Title: Chairman, Chief Executive Officer, Chief Financial Officer, Secretary and Treasurer |
/s/ Paul DiPerna | 01/05/2021 | |
** 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. |