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