0001493152-21-000075.txt : 20210104 0001493152-21-000075.hdr.sgml : 20210104 20210104164852 ACCESSION NUMBER: 0001493152-21-000075 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201231 FILED AS OF DATE: 20210104 DATE AS OF CHANGE: 20210104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lai John CENTRAL INDEX KEY: 0001302378 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55167 FILM NUMBER: 21502376 MAIL ADDRESS: STREET 1: 12100 SINGLETREE LANE STREET 2: SUITE 186 CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PetVivo Holdings, Inc. CENTRAL INDEX KEY: 0001512922 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 990363559 STATE OF INCORPORATION: NV FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 5251 EDINA INDUSTRIAL BLVD CITY: EDINA STATE: MN ZIP: 55439 BUSINESS PHONE: (952) 217-4952 MAIL ADDRESS: STREET 1: 5251 EDINA INDUSTRIAL BLVD CITY: EDINA STATE: MN ZIP: 55439 FORMER COMPANY: FORMER CONFORMED NAME: Technologies Scan Corp DATE OF NAME CHANGE: 20110211 4 1 ownership.xml X0306 4 2020-12-31 0 0001512922 PetVivo Holdings, Inc. PETV 0001302378 Lai John 5251 EDINA INDUSTRIAL BLVD EDINA MN 55439 1 1 1 0 CEO Common Stock 2020-12-31 4 M 0 38516 A 871077 D Common Stock Warrant 1.3333 2020-12-31 4 C 0 42188 D 2018-12-31 2020-12-31 Common Stock 42188 229000 D John Lai converted 42,188 warrants for common stock with an exercise & conversion price of $1.33 per share into 38,516 shares of common stock on a cashless basis pursuant to the warrant for common stock's cashless conversion feature. /s/ John Lai 2021-01-04