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