0001096906-17-000065.txt : 20170202
0001096906-17-000065.hdr.sgml : 20170202
20170202172737
ACCESSION NUMBER: 0001096906-17-000065
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170131
FILED AS OF DATE: 20170202
DATE AS OF CHANGE: 20170202
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ACTIVECARE, INC.
CENTRAL INDEX KEY: 0001429896
STANDARD INDUSTRIAL CLASSIFICATION: COMMUNICATIONS EQUIPMENT, NEC [3669]
IRS NUMBER: 870578125
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0930
BUSINESS ADDRESS:
STREET 1: 1365 WEST BUSINESS PARK DRIVE, SUITE 100
CITY: OREM
STATE: UT
ZIP: 84058
BUSINESS PHONE: 877-219-6050
MAIL ADDRESS:
STREET 1: 1365 WEST BUSINESS PARK DRIVE, SUITE 100
CITY: OREM
STATE: UT
ZIP: 84058
FORMER COMPANY:
FORMER CONFORMED NAME: Volu-Sol Reagents CORP
DATE OF NAME CHANGE: 20080317
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PETERSON JEFFREY S
CENTRAL INDEX KEY: 0001575497
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-53570
FILM NUMBER: 17569447
MAIL ADDRESS:
STREET 1: 539 EAST BLACKHAWK LN
CITY: ALPINE
STATE: UT
ZIP: 84004
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2017-01-31
0
0001429896
ACTIVECARE, INC.
ACAR
0001575497
PETERSON JEFFREY S
539 EAST BLACKHAWK LN
ALPINE
UT
84004
1
1
1
0
CEO
Series G Preferred Stock
2017-01-31
4
A
0
32415
A
Common Stock
32415
D
A class of Series G Convertible Preferred Stock ("Series G") was created on January 31, 2017. Mr. Peterson was issued 32,415 shares of Series G stock. The Series G automatically converts into common stock only upon the happening of certain specified events. Each share of Series G has a stated value of $500. The Series G converts into common stock at the stated value of such shares at the time of conversion.
/s/ Jeffrey S. Peterson
2017-02-02