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
POWER 3 MEDICAL PRODUCTS INC [ PWRM ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 11/18/2008 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) 02/17/2009 |
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, $0.001 par value(1) | 11/18/2008 | D | V | 5,000,000 | D | (2) | 0 | D |
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 | ||||||||
Convertible promissory note(1) | $0.03 | 11/18/2008 | A | V | 5,000,000 | 11/18/2008 | 11/18/2009 | Common Stock | 5,000,000 | (3) | 5,000,000 | I | See Footnote(4) | ||
Stock warrants(1) | $0.04 | 11/18/2008 | A | V | 5,000,000 | 11/18/2008 | 11/18/2011 | Common Stock | 5,000,000 | (3) | 5,000,000 | I | See Footnote(4) |
Explanation of Responses: |
1. This amendment is being filed to: (i) disclose the return of 5,000,000 shares of common stock to the issuer in exchange for a convertible promissory note and stock warrants, (ii) remove the disclosure relating to the issuance of 1,500,000 shares of common stock to the reporting person on July 31, 2004, (iii) update the nature of the direct and indirect ownership of the convertible promissory note and stock warrants and (iv) correct certain typographical errors. |
2. These securities were returned by the reporting person to the issuer in exchange for the promissory note dated 11/18/08 convertible into 5,000,000 shares of common stock at an exercise price of $0.03 per share and the stock warrants exercisable into 5,000,000 shares of common stock at an exercise price of $0.04 per share. |
3. These securities were issued to the reporting person in exchange for the return to the issuer of 5,000,000 shares of common stock issued to the reporting person on October 7, 2008. |
4. These securities were issued to Bronco Technology, Inc., a company of which the reporting person owns all of the issued and outstanding capital stock. |
/s/ Helen R. Park | 03/18/2010 | |
** 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. |