0001209191-13-006375.txt : 20130205
0001209191-13-006375.hdr.sgml : 20130205
20130205154057
ACCESSION NUMBER: 0001209191-13-006375
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130201
FILED AS OF DATE: 20130205
DATE AS OF CHANGE: 20130205
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MILLER LLOYD I III
CENTRAL INDEX KEY: 0000949119
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-13117
FILM NUMBER: 13573801
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2013-02-01
0
0000754813
HealthWarehouse.com, Inc.
HEWA
0000949119
MILLER LLOYD I III
222 LAKEVIEW AVENUE
SUITE 160-365
WEST PALM BEACH
FL
33401
0
0
1
0
Common Stock
716484
I
By Milfam I L.P.
7% Senior Secured Convertible Promissory Note
9.45
2013-02-01
4
J
0
581930.41
581930.41
D
2010-11-08
2012-12-31
Common Stock
307900
0
I
By Milfam I L.P.
Series B Preferred Stock
0.00
2010-11-08
Common Stock
948980
948980
I
By Milfam I L.P.
The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. This filing shall not be deemed an admission that the reporting person is, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of any equity securites covered by this filing.
Prior to its redemption, the 7% Senior Secured Convertible Note was immediately convertible into 61,580 shares of Series B Preferred Stock (at a price of $9.45 per share), each share of which was immediately convertible into 5 shares of common stock.
The 7% Senior Secured Convertible Note was redeemed in full (including the full principal amount and all accrued and unpaid interest) by the issuer on February 1, 2013.
See Footnote 2.
The reporting person holds 189,796 shares of Series B Preferred Stock. This amount includes 11,605 shares of Series B Preferred Stock representing a dividend for the year 2011 and 12,417 shares of Series B Preferred Stock representing a dividend for the year 2012. Each share of Series B Preferrred Stock is immediately convertible into 5 shares of common stock.
N/A
/s/ David J. Hoyt
Attorney-in-fact
2013-02-05