0001415889-19-001134.txt : 20191002 0001415889-19-001134.hdr.sgml : 20191002 20191002215910 ACCESSION NUMBER: 0001415889-19-001134 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190930 FILED AS OF DATE: 20191002 DATE AS OF CHANGE: 20191002 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: 191134331 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 form4-10022019_061055.xml X0306 4 2019-09-30 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 35862136 D Common Stock 382300 I By IRA Account Common Stock 1500 I By IRA SEP Account Common Stock 717500 I By Elaine M. Korenko Bypass Trust Common Stock 45000 I By Michael Korenko ROTH IRA Common Stock 45000 I By Robert Korenko ROTH IRA Common Stock 10000 I By Robert Korenko Options .024 2019-09-30 4 A 0 15750000 .024 A 2029-06-04 Common Stock 15750000 15750000 D Series A Convertible Pref erred Stock 0.50 2017-09-01 Common Stock 1000000 100000 D Warrants 0.01 2018-10-24 2020-10-24 Common Stock 14098568 14098568 D Options 0.014 2018-10-24 2025-10-24 Common Stock 64961214 64961214 D Warrants 0.01 2018-10-10 2020-10-10 Common Stock 1800000 1800000 D The Reporting P erson disclaims beneficial ownership with respect to these shares. The Reporting P erson has trading authority only with respect to these shares. These options vested as follows: 25% on September 30, 2019; and 50% based on performance metrics being met and certified by the Board of Directors effective September 30, 2019. Not applicable as Series A Convertible P referred Stock does not have an expiration date. /s/ /s/ Michael K. Korenko 2019-10-02