-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, MJkJYMJvyg5SvSh01K629Od/jCycWss5DMIIwRpqGN56OooJ31RSY6WNxh1TPGxx sAs9N9w7s1NuSXTLDQv8mA== 0001209191-07-039565.txt : 20070629 0001209191-07-039565.hdr.sgml : 20070629 20070629180756 ACCESSION NUMBER: 0001209191-07-039565 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070629 FILED AS OF DATE: 20070629 DATE AS OF CHANGE: 20070629 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: UNIVERSAL BIOSENSORS INC CENTRAL INDEX KEY: 0001279695 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 980424072 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 103 RICKETTS ROAD STREET 2: MT. WAVERLEY CITY: VICTORIA STATE: C3 ZIP: 3149 BUSINESS PHONE: 613-8542-9000 MAIL ADDRESS: STREET 1: 103 RICKETTS ROAD STREET 2: MT. WAVERLEY CITY: VICTORIA STATE: C3 ZIP: 3149 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jane Andrew CENTRAL INDEX KEY: 0001397477 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-52607 FILM NUMBER: 07952453 BUSINESS ADDRESS: BUSINESS PHONE: 613 8542-9000 MAIL ADDRESS: STREET 1: 103 RICKETTS ROAD STREET 2: MT. WAVERLEY CITY: VICTORIA STATE: C3 ZIP: 3149 3 1 doc3.xml FORM 3 SUBMISSION X0202 3 2007-06-29 0 0001279695 UNIVERSAL BIOSENSORS INC UBI 0001397477 Jane Andrew 103 RICKETTS ROAD MT. WAVERLEY VICTORIA C3 3149 AUSTRALIA 1 0 1 0 Common Stock 15196879 I By CM Capital Investments Pty Ltd The Reporting Person is a partner of CM Capital Investments Pty Ltd and has an indeterminate interest in the Reported Securities which are held by CM Capital Investments Pty Ltd and CIBC Australia VC Fund LLC. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. CM Capital Investments Pty Ltd holds 11,688,767 shares of the reported securities as trustee of the CM Capital Venture Trust No. 3. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of its pecuniary interest therein. CIBC Australia VC Fund LLC holds 3,508,112 shares of the reported securities as general partner of the Australia Venture Capital Fund L.P., of which CM Capital Investments Pty Ltd is a special limited partner. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of its pecuniary interest therein. /s/ Andrew Jane 2007-06-29 -----END PRIVACY-ENHANCED MESSAGE-----