-----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, PicFn8V162DZNMIXMAwB0G3UTpHdVTxORNk0L5WQGxo9+mSXoj3ZT5wRRHV5cEtV K2M17yJ8Y8ZPjX9ra1Ps3Q== 0001209191-10-003256.txt : 20100114 0001209191-10-003256.hdr.sgml : 20100114 20100114190030 ACCESSION NUMBER: 0001209191-10-003256 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100112 FILED AS OF DATE: 20100114 DATE AS OF CHANGE: 20100114 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HSIAO JANE PH D CENTRAL INDEX KEY: 0001188834 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19437 FILM NUMBER: 10528589 MAIL ADDRESS: STREET 1: 4400 BISCAYNE BLVD CITY: MIAMI STATE: FL ZIP: 33137 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SafeStitch Medical, Inc. CENTRAL INDEX KEY: 0000876378 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 112962080 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4400 BISCAYNE BLVD. STREET 2: SUITE 980 CITY: MIAMI STATE: FL ZIP: 33137 BUSINESS PHONE: 305-525-4146 MAIL ADDRESS: STREET 1: 4400 BISCAYNE BLVD. STREET 2: SUITE 980 CITY: MIAMI STATE: FL ZIP: 33137 FORMER COMPANY: FORMER CONFORMED NAME: CELLULAR TECHNICAL SERVICES CO INC DATE OF NAME CHANGE: 19930328 4 1 doc4.xml FORM 4 SUBMISSION X0303 4 2010-01-12 0 0000876378 SafeStitch Medical, Inc. SFES.OB 0001188834 HSIAO JANE PH D 4400 BISCAYNE BLVD MIAMI FL 33137 1 0 1 1 Chairman of the Board 10% Series A Convertible Preferred Stock 1.00 2010-01-12 4 P 0 447500 1.00 A 2010-01-12 Common Stock, par value $0.001 per share 447500 447500 I Hsu Gamma Investments, L.P. Subject to adjustment for stock splits and other combinations involving the Issuer's common stock, par value $0.001 per share ("Common Stock"), including in the event that the Issuer issues, or is deemed to have issued, Common Stock for consideration of less than $1.00 per share, as described in the Certificate of Designation of the Powers, Preferences and Relative, Participating, Optional and Other Special Rights of 10.0% Series A Cumulative Convertible Preferred Stock, and Qualifications, Limitations and Restrictions Thereof, filed as Exhibit 3.1 to the Issuer's Current Report on Form 8-K, filed with the SEC on July 23, 2009. The 10% Series A Convertible Preferred Stock has no expiration date. Dr. Hsiao is the general partner of Hsu Gamma Investments, L.P. and disclaims benenficial ownership in the shares held by such entity except to the extent of her pecuniary interest therein. /s/ Jane Hsiao 2010-01-14 -----END PRIVACY-ENHANCED MESSAGE-----