0001415889-18-001611.txt : 20181113
0001415889-18-001611.hdr.sgml : 20181113
20181113060040
ACCESSION NUMBER: 0001415889-18-001611
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181010
FILED AS OF DATE: 20181113
DATE AS OF CHANGE: 20181113
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Korenko Michael K
CENTRAL INDEX KEY: 0001486806
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-53497
FILM NUMBER: 181174593
MAIL ADDRESS:
STREET 1: 6208 W OKANOGAN AVE
CITY: KENNEWICK
STATE: WA
ZIP: 99336
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: VIVOS INC
CENTRAL INDEX KEY: 0001449349
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 800138937
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 719 JADWIN AVENUE
CITY: RICHLAND
STATE: WA
ZIP: 99352
BUSINESS PHONE: 509-736-4000
MAIL ADDRESS:
STREET 1: 719 JADWIN AVENUE
CITY: RICHLAND
STATE: WA
ZIP: 99352
FORMER COMPANY:
FORMER CONFORMED NAME: ADVANCED MEDICAL ISOTOPE Corp
DATE OF NAME CHANGE: 20081103
4
1
form4-11132018_061102.xml
X0306
4
2018-10-10
0001449349
VIVOS INC
RDGL
0001486806
Korenko Michael K
C/O VIVOS INC
719 JADWIN AVENUE
RICHLAND
WA
99352
false
true
false
false
CEO AND PRESIDENT
Common Stock
2018-10-24
4
A
0
28197136
A
34427136
D
Common Stock
2018-10-10
4
A
0
3600000
A
38027136
D
Warrants
0.01
2018-10-24
4
A
0
14098568
A
2018-10-24
2020-10-24
Common Stock
14098568
14098568
D
Options
0.014
2018-10-24
4
A
0
64961214
A
2018-10-24
2025-10-24
Common Stock
64961214
64961214
D
Warrants
0.01
2018-10-10
4
A
0
1800000
A
2018-10-10
2020-10-10
Common Stock
1800000
1800000
D
Represents securities issued in lieu of cash owed to the Reporting Person for past services rendered to the Issuer in his capacity as Chief Executive Officer and President.
On October 10, 2018, in connection with a private placement consummated by the Issuer on such date, the Reporting Person agreed to terminate a bridge note with an outstanding balance of $15,000 ("Outstanding Balance") in exchange for the issuance of $18,000 of units, or 120% of the Outstanding Balance, consisting of 3,600,000 shares of the Issuer's common stock and warrants to purchase 1,800,000 shares of the Issuer's common stock.
Represents securities issued to the Reporting Person as a bonus for services rendered to the Issuer in his capacity as Chief Executive Officer and President.
/s/ Michael K. Korenko
2018-11-13