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
Medytox Solutions, Inc. [ MMMS ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 02/05/2013 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) 03/21/2014 |
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 | 02/05/2013 | 02/05/2013 | G | V | 4,500,000(1) | D | $0 | 0 | D | |
Common Stock | 02/05/2013 | 02/05/2013 | G | V | 4,500,000(1) | A | $0 | 4,500,000 | I | By Aella Ltd.(1) |
Common Stock | 02/08/2013 | 02/08/2013 | J(2) | V | 4,500,000 | D | $0 | 0 | I | See note(2) |
Series B Non-Convertible Preferred Stock | 02/05/2013 | 02/05/2013 | G | V | 1,000(3) | D | $0 | 0 | D | |
Series B Non-Convertible Preferred Stock | 02/05/2013 | 02/05/2013 | G | V | 1,000(3) | A | $0 | 1,000 | I | By Aella Ltd.(3) |
Series B Non-Convertible Preferred Stock | 02/08/2013 | 02/08/2013 | J(2) | V | 1,000 | D | $0 | 0 | I | See note(2) |
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 |
Explanation of Responses: |
1. This Form 4 amends these transactions which were previously reported with an incorrect transaction date of September 27, 2013. As previously reported, the 4,500,000 shares of the Issuer's Common Stock were distributed by the Reporting Person to Aella Ltd., and as of February 5, 2013 were indirectly owned by the Reporting Person. On February 5, 2013, the Reporting Person was the sole owner of Aella Ltd., and disclaims beneficial ownership of the reported securities, except to the extent of her pecuniary interest therein. |
2. On February 8, 2013, the Reporting Person distributed all of the capital stock of Aella Ltd. to The Olive Tree Trust. P. Wilhelm F. Toothe is the trustee of The Olive Tree Trust. The Reporting Person is the settlor and the Reporting Person and her family are the beneficiaries of The Olive Tree Trust. As a consequence of the distribution of all of the capital stock of Aella Ltd. to The Olive Tree Trust, the Reporting Person is no longer a beneficial owner of the Issuer's Common Stock and the Issuer's Series B Non-Convertible Preferred Stock owned of record by Aella Ltd. pursuant to Section 16(a) of the Securities Exchange Act of 1934. |
3. The 1,000 shares of the Issuer's Series B Non-Convertible Preferred Stock were distributed by the Reporting Person to Aella Ltd., and as of February 5, 2013 were indirectly owned by the Reporting Person. On February 5, 2013, the Reporting Person was the sole owner of Aella Ltd., and disclaims beneficial ownership of the reported securities, except to the extent of her pecuniary interest therein. |
/s/ Sharon Lynne Hollis | 03/31/2015 | |
** 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. |