SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
GIRSCHWEILER THOMAS

(Last) (First) (Middle)
C/O BIOLIFE SOLUTIONS, INC.
3303 MONTE VILLA PARKWAY

(Street)
BOTHELL WA 98021

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
BIOLIFE SOLUTIONS INC [ BLFS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
12/31/2005
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Shares 12/31/2005 P(1) 1,761,827 A $0.12 2,299,887 D
Common Shares 05/01/2006 P(2) 479,999 A $0.06 13,989,886(3) D
Common Shares 02/13/2007 J(4) 416,666 A $0 14,406,552 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Common Share Warrants $0.07 11/29/2010 J(5) 1,000,000 11/29/2010 11/29/2015 Common Shares 1,000,000 $0 1,000,000 D
Common Share Warrants $0.063 08/10/2011 J(6) 1,000,000 08/10/2011 08/30/2016 Common Shares 1,000,000 $0 1,000,000 D
Explanation of Responses:
1. Resulting purchase from cash dividends paid to Series G preferred stockholders; purchase price based on December 31, 2005 closing price of Issuer?s common shares.
2. Resulting purchase from cash dividend paid to Series G preferred stockholders; purchase price based on May 1, 2006 closing price of Issuer's common shares.
3. Total includes 11,210,000 common shares acquired upon conversion of Series F and Series G preferred shares and warrants previously reported on Form 4 filed on April 18, 2006 and 538,060 common shares previously held.
4. Shares of common stock issued to reporting person in connection with financing costs related to Secured Multi-Draw Term Loan Facility Agreement in the amount of $2,000,000, with a maturity date of January 11, 2010.
5. Warrants acquired as consideration for an amendment to the issuer's Secured Multi-Draw Term Loan Facility Agreement, increasing the reporting person's "Facility?" to $4,750,000 and extending the maturity date to January 11, 2013.
6. Warrants acquired as consideration for an amendment to the issuer's Secured Multi-Draw Term Loan Facility Agreement, increasing the reporting person's "Facility"? to $5,250,000.
/s/ Thomas Girschweiler 04/29/2013
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.