-----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, KbC/hRCcPw9EDjPHswPk3wcSNmMcquiOPN5EnEFIX36IY/poWSdoTwQURC7WfuLy TtoeSVGjZHseNPc+DfH51w== 0001157523-06-008485.txt : 20060815 0001157523-06-008485.hdr.sgml : 20060815 20060815162901 ACCESSION NUMBER: 0001157523-06-008485 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20060811 FILED AS OF DATE: 20060815 DATE AS OF CHANGE: 20060815 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PHASE III MEDICAL INC/DE CENTRAL INDEX KEY: 0000320017 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] 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: Smith Robin L CENTRAL INDEX KEY: 0001365035 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-10909 FILM NUMBER: 061035638 BUSINESS ADDRESS: BUSINESS PHONE: 631-574-4955 MAIL ADDRESS: STREET 1: C/O PHASE III MEDICAL, INC. STREET 2: 330 SOUTH SERVICE ROAD, SUITE 120 CITY: MELVILLE STATE: NY ZIP: 11747 4 1 a5210195_ex.xml X0202 4 2006-08-11 0 0000320017 PHASE III MEDICAL INC/DE PHSM 0001365035 Smith Robin L C/O PHASE III MEDICAL, INC. 420 LEXINGTON AVENUE, SUITE 450 NEW YORK NY 10170 1 1 0 0 Chairman and CEO Common Stock, $.001 par value 2006-08-11 4 C 0 284090 0.044 A 4284090 D Common Stock, $.001 par value 2006-08-11 4 J 0 56818 A 4340908 D 9% Convertible Promissory Notes due 2006 0.06 2006-08-11 4 J 0 208333 D 2006-09-30 Common Stock 208333 208333 D 9% Convertible Promissory Notes due 2006 0.044 2006-08-11 4 J 0 284090 A 2006-09-30 Common Stock 284090 284090 D 9% Convertible Promissory Notes due 2006 0.044 2006-08-11 4 C 0 284090 D 2006-09-30 Common Stock 284090 0 D Warrants (right to buy) 0.12 2006-08-11 4 J 0 208333 D 2008-12-29 Common Stock 208333 208333 D Warrants (right to buy) 0.08 2006-08-11 4 J 0 208333 A 2008-12-29 Common Stock 208333 208333 D Warrants (right to buy) 0.08 2006-08-11 4 J 0 208333 A 2008-12-29 Common Stock 208333 208333 D On August 11, 2006, Dr. Smith executed an agreement with Phase III Medical Inc. (the "Company") pursuant to which Dr. Smith agreed to convert that certain 9% Convertible Promissory Note issued December 30, 2005. As consideration for entering into such agreement, the Company agreed to: (i) reduce the conversion price of the convertible promissory note from $.06 per share to $.044 per share, (ii) to reduce the exercise price of certain warrants held by Dr. Smith from $0.12 to $0.08 per share, (iii) issue 56,818 shares of the Company's common stock to Dr. Smith, and (iv) grant to Dr. Smith a warrant to purchase 208,333 shares of common stock of the Company at an exercise price of $0.08 per share. The convertible promissory note is convertible immediately. These warrants are exercisable immediately. /s/ Catherine M. Vaczy, Esq., Attorney-In-Fact 2006-08-15 -----END PRIVACY-ENHANCED MESSAGE-----