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