-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, TCiE4kEZOSTMOPGaRnwoTYquX+xt9brDQaq7qLs/LjjNW0h6htet8ly3j0FPw3sG hyje0hZBCqTVxSohIhecCQ== 0001157523-05-010596.txt : 20051202 0001157523-05-010596.hdr.sgml : 20051202 20051202210420 ACCESSION NUMBER: 0001157523-05-010596 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051130 FILED AS OF DATE: 20051202 DATE AS OF CHANGE: 20051202 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PHASE III MEDICAL INC/DE CENTRAL INDEX KEY: 0000320017 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE CARRIERS, NEC [6399] IRS NUMBER: 222343568 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 330 SOUTH SERVICE ROAD STREET 2: SUITE 120 CITY: MELVILLE STATE: NY ZIP: 11747 BUSINESS PHONE: 6315744955 MAIL ADDRESS: STREET 1: 330 SOUTH SERVICE ROAD STREET 2: SUITE 120 CITY: MELVILLE STATE: NY ZIP: 11747 FORMER COMPANY: FORMER CONFORMED NAME: CORNICHE GROUP INC /DE DATE OF NAME CHANGE: 19951117 FORMER COMPANY: FORMER CONFORMED NAME: FIDELITY MEDICAL INC DATE OF NAME CHANGE: 19951025 FORMER COMPANY: FORMER CONFORMED NAME: FIDELITY MEDICAL SERVICES INC DATE OF NAME CHANGE: 19830825 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WEINREB MARK CENTRAL INDEX KEY: 0001015279 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-10909 FILM NUMBER: 051242626 BUSINESS ADDRESS: STREET 1: C/O BIG CITY BAGELS STREET 2: 99 WOODBURY RD CITY: HICKSVILLE STATE: NY ZIP: 11801 BUSINESS PHONE: 5169325050 MAIL ADDRESS: STREET 1: C/O BIG CITY BAGELS INC STREET 2: 600 THIRD AVE CITY: HICKVILLE STATE: NY ZIP: 11801 4 1 a5032712_ex.xml X0202 4 2005-11-30 0 0000320017 PHASE III MEDICAL INC/DE PHSM.OB 0001015279 WEINREB MARK C/O PHASE III MEDICAL, INC. 330 SOUTH SERVICE ROAD, SUITE 120 MELVILLE NY 11747 1 1 0 0 President & CEO Common Stock, $.001 par value 2005-11-30 4 P 0 595000 A 3635000 D As of November 30, 2005, Mr. Weinreb participated in an exchange offer made by the Company to holders of its outstanding promissory notes (the "Exchange Offer"). Pursuant to the Exchange Offer, Mr. Weinreb exchanged a promissory note in the principal amount of $35,000 representing indebtedness of the Company to him into 595,000 shares of the Company's restricted common stock, $.001 par value (the "Common Stock") based on an exchange ratio of 17,000 shares of Common Stock per $1,000 of outstanding indebtedness. /s/ Catherine M. Vaczy as attorney in fact 2005-12-02 -----END PRIVACY-ENHANCED MESSAGE-----