0001209191-17-032894.txt : 20170516
0001209191-17-032894.hdr.sgml : 20170516
20170516211325
ACCESSION NUMBER: 0001209191-17-032894
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170512
FILED AS OF DATE: 20170516
DATE AS OF CHANGE: 20170516
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ENDRA Life Sciences Inc.
CENTRAL INDEX KEY: 0001681682
STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845]
IRS NUMBER: 260579295
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3600 GREEN COURT
STREET 2: SUITE 350
CITY: ANN ARBOR
STATE: MI
ZIP: 48105
BUSINESS PHONE: 734-335-0468
MAIL ADDRESS:
STREET 1: 3600 GREEN COURT
STREET 2: SUITE 350
CITY: ANN ARBOR
STATE: MI
ZIP: 48105
FORMER COMPANY:
FORMER CONFORMED NAME: Endra Inc.
DATE OF NAME CHANGE: 20160805
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Michelon Francois Roger
CENTRAL INDEX KEY: 0001691470
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37969
FILM NUMBER: 17850162
MAIL ADDRESS:
STREET 1: 430 N. JUNO LANE
CITY: JUNO BEACH
STATE: FL
ZIP: 33406
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-05-12
0
0001681682
ENDRA Life Sciences Inc.
NDRA
0001691470
Michelon Francois Roger
C/O ENDRA LIFE SCIENCES INC.
3600GREEN COURT, SUITE 350
ANN ARBOR
MI
48105
1
1
0
0
Chief Executive Officer
Common Stock
2017-05-12
4
C
0
26544
1.40
A
26544
D
Convertible Promissory Note
1.40
2017-05-12
4
C
0
37163.00
0.00
D
2017-05-12
Common Stock
37163.00
0.00
D
Stock Options
5.00
2017-05-12
4
A
0
307310
0.00
A
2022-05-12
Common Stock
307310
307310
D
These shares of Common Stock were issued upon the conversion of the Convertible Promissory Note, as described in footnote (2).
The principal amount of, and accrued interest on, the Convertible Promissory Note converted into shares of Common Stock of the Issuer at a
conversion price of $1.40 per share immediately prior to the consummation of the Issuer's initial public offering.
These Stock Options become exercisable in three equal annual installments beginning on May 12, 2018.
/s/ Francois R. Michelon by Mark Bush, attorney-in-fact
2017-05-16