0001019056-21-000606.txt : 20211130
0001019056-21-000606.hdr.sgml : 20211130
20211130141118
ACCESSION NUMBER: 0001019056-21-000606
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211129
FILED AS OF DATE: 20211130
DATE AS OF CHANGE: 20211130
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Sheibley Philip Brent
CENTRAL INDEX KEY: 0001895043
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-49671
FILM NUMBER: 211459184
MAIL ADDRESS:
STREET 1: C/O MODULAR MEDICAL, INC.
STREET 2: 16772 W. BERNARDO DRIVE
CITY: SAN DIEGO
STATE: CA
ZIP: 92127
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Modular Medical, Inc.
CENTRAL INDEX KEY: 0001074871
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 870620495
STATE OF INCORPORATION: NV
FISCAL YEAR END: 0331
BUSINESS ADDRESS:
STREET 1: 16772 WEST BERNARDO DRIVE
CITY: SAN DIEGO
STATE: CA
ZIP: 92127
BUSINESS PHONE: 858-800-3500
MAIL ADDRESS:
STREET 1: 16772 WEST BERNARDO DRIVE
CITY: SAN DIEGO
STATE: CA
ZIP: 92127
FORMER COMPANY:
FORMER CONFORMED NAME: BEAR LAKE RECREATION INC
DATE OF NAME CHANGE: 19981208
4
1
sheibley.xml
X0306
4
2021-11-29
0
0001074871
Modular Medical, Inc.
MODD
0001895043
Sheibley Philip Brent
C/O MODULAR MEDICAL, INC.
16772 W. BERNARDO DRIVE
SAN DIEGO
CA
92127
1
0
0
0
Option to purchase common stock
10.20
2021-11-29
4
A
0
16667
10.20
A
2022-11-29
2031-11-29
Common Stock
16667
16667
D
This option will vest as to one-third of the shares subject to the option on each annual anniversary of November 29, 2021.
/s/ Philip Brent Sheibley
2021-11-30