0001654954-24-007460.txt : 20240606
0001654954-24-007460.hdr.sgml : 20240606
20240606182529
ACCESSION NUMBER: 0001654954-24-007460
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240605
FILED AS OF DATE: 20240606
DATE AS OF CHANGE: 20240606
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PAYNE JOHN BERNARD
CENTRAL INDEX KEY: 0001582392
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40449
FILM NUMBER: 241026696
MAIL ADDRESS:
STREET 1: 9900 NE 114TH CIRCLE
CITY: VANCOUVER
STATE: WA
ZIP: 98662
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Zivo Bioscience, Inc.
CENTRAL INDEX KEY: 0001101026
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
ORGANIZATION NAME: 03 Life Sciences
IRS NUMBER: 870699977
STATE OF INCORPORATION: NV
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 21 E. LONG LAKE ROAD
STREET 2: SUITE 100
CITY: BLOOMFIELD HILLS
STATE: MI
ZIP: 48304
BUSINESS PHONE: (248) 452 9866
MAIL ADDRESS:
STREET 1: 21 E. LONG LAKE ROAD
STREET 2: SUITE 100
CITY: BLOOMFIELD HILLS
STATE: MI
ZIP: 48304
FORMER COMPANY:
FORMER CONFORMED NAME: HEALTH ENHANCEMENT PRODUCTS INC
DATE OF NAME CHANGE: 20040202
FORMER COMPANY:
FORMER CONFORMED NAME: WESTERN GLORY HOLE INC
DATE OF NAME CHANGE: 19991215
4
1
section16.xml
FORM 4
X0508
4
2024-06-05
0001101026
Zivo Bioscience, Inc.
ZIVO
0001582392
PAYNE JOHN BERNARD
9900 NE 114TH CIRCLE
VANCOUVER
WA
98662
true
true
false
false
President and CEO
false
Nonstatutory Stock Option to Purchase Common Stock
26.88
2024-06-05
4
D
false
1902
D
2031-10-11
Common Stock
1902
0
D
Nonstatutory Stock Option to Purchase Common Stock
33.00
2024-06-05
4
D
false
32000
D
2031-10-20
Common Stock
32000
0
D
Nonstatutory Stock Option to Purchase Common Stock
17.16
2024-06-05
4
D
false
31836
D
2032-12-15
Common Stock
31836
0
D
Nonstatutory Stock Option to Purchase Common Stock
7.96
2024-06-05
4
A
false
167180
A
2034-06-04
Common Stock
167180
167180
D
Nonstatutory Stock Option to Purchase Common Stock
7.96
2024-06-05
4
A
false
50251
0
A
2034-06-04
Common Stock
50251
50251
D
The share amount and exercise price have been adjusted from the amount reported on a previous Form 4 to reflect a 1 for 6 reverse stock split of the Issuer's stock in October 2023.
The canceled options were fully vested.
The Issuer canceled options for an aggregate 65,738 shares of the Issuer's common stock granted to the Reporting Person on 10/12/2021, 10/21/2021, and 12/16/2022. In exchange for the canceled options, the Reporting Person received a replacement option, for 167,180 shares, having an exercise price of $7.96.
The option was issued pursuant to the 2021 Equity Incentive Plan and all options vested immediately upon the date of acceptance of grant.
/s/ John B. Payne
2024-06-06