0001181431-13-004275.txt : 20130123 0001181431-13-004275.hdr.sgml : 20130123 20130123130814 ACCESSION NUMBER: 0001181431-13-004275 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121231 FILED AS OF DATE: 20130123 DATE AS OF CHANGE: 20130123 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Backus John C CENTRAL INDEX KEY: 0001362651 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13117 FILM NUMBER: 13542272 MAIL ADDRESS: STREET 1: DRAPER ATLANTIC STREET 2: 11911 FREEDOM DRIVE, SUITE 1080 CITY: RESTON STATE: VA ZIP: 20191 FORMER NAME: FORMER CONFORMED NAME: Backus John G DATE OF NAME CHANGE: 20060512 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HealthWarehouse.com, Inc. CENTRAL INDEX KEY: 0000754813 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DRUG STORES AND PROPRIETARY STORES [5912] IRS NUMBER: 222413505 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7107 INDUSTRIAL ROAD CITY: FLORENCE STATE: KY ZIP: 41042 BUSINESS PHONE: (513) 618-0911 MAIL ADDRESS: STREET 1: 7107 INDUSTRIAL ROAD CITY: FLORENCE STATE: KY ZIP: 41042 FORMER COMPANY: FORMER CONFORMED NAME: HealthWarehouse, Inc. DATE OF NAME CHANGE: 20090818 FORMER COMPANY: FORMER CONFORMED NAME: CLACENDIX, INC. DATE OF NAME CHANGE: 20080107 FORMER COMPANY: FORMER CONFORMED NAME: ION NETWORKS INC DATE OF NAME CHANGE: 19990413 5 1 rrd367465.xml FORM 5 X0306 5 2012-12-31 0 0 1 0000754813 HealthWarehouse.com, Inc. HEWA 0001362651 Backus John C 11911 FREEDOM DRIVE, SUITE 1080 RESTON VA 20190 1 0 1 0 Employee Stock Option (Right to Buy) 6.99 2012-03-30 4 A 0 15000 0.00 A 2022-03-30 Common Stock 15000 15000 D Option granted on March 30, 2012 under the HealthWarehouse.com, Inc. 2009 Incentive Compensation Plan. Options vest annually in three equal installments on March 30, of 2013, 2014 and 2015. /s/ John C. Backus 2013-01-23