SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
Micallef Jacob Vincent

(Last) (First) (Middle)
1 SCOTTS ROAD
#24-05 SHAW CENTRE

(Street)
SINGAPORE U0 228208

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/18/2015
3. Issuer Name and Ticker or Trading Symbol
VOLITIONRX LTD [ VNRX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Scientific Officer
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common 86,166 D
Common 14,290 I(1) Borlaug Limited
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Warrant (Right to Buy) 05/11/2012 05/10/2016 Common Stock 5,000 $2.6 I(3) Borlaug Limited
Stock Option (Right to Buy) 05/25/2012 05/25/2016 Common Stock 20,000 $3 I(2) Borlaug Limited
Stock Option (Right to Buy) 11/25/2012 11/25/2016 Common Stock 20,000 $3 I(2) Borlaug Limited
Stock Option (Right to Buy) 05/25/2013 05/25/2017 Common Stock 20,000 $4 I(2) Borlaug Limited
Stock Option (Right to Buy) 11/25/2013 11/25/2017 Common Stock 20,000 $4 I(2) Borlaug Limited
Stock Option (Right to Buy) 05/25/2014 05/25/2018 Common Stock 20,000 $5 I(2) Borlaug Limited
Stock Option (Right to Buy) 11/25/2014 11/25/2018 Common Stock 20,000 $5 I(2) Borlaug Limited
Stock Option (Right to Buy) 12/13/2012 12/13/2015 Common Stock 50,000 $3.01 I(2) Borlaug Limited
Warrant (Right to Buy) 11/25/2013 11/25/2018 Common Stock 4,290 $2.4 I(3) Borlaug Limited
Warrant (Right to Buy) 02/26/2014 02/26/2019 Common Stock 10,000 $2.2 D
Stock Option (Right to Buy) 02/18/2015 02/18/2019 Common Stock 65,000 $2.5 I(2) Borlaug Limited
Stock Option (Right to Buy) 02/18/2016 02/18/2020 Common Stock 65,000 $3 I(2) Borlaug Limited
Stock Option (Right to Buy) 01/23/2016 01/23/2020 Common Stock 55,000 $4 I(2) Borlaug Limited
Explanation of Responses:
1. These shares of Common Stock are owned of record by Borlaug Limited, which is a consulting firm. Dr. Micallef is a controlling director of Borlaug Limited and has voting and dispositive control over these shares. However, Dr. Micallef disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
2. These options to purchase Common Stock were granted pursuant to the Issuer's 2011 Equity Incentive Plan dated November 17, 2011, and are owned of record by Borlaug Limited, which is a consulting firm. Dr. Micallef is a controlling director of Borlaug Limited and has voting and dispositive control over the Common shares issuable to Borlaug Limited upon the exercise of these options. However, Dr. Micallef disclaims beneficial ownership of these Options and Warrants except to the extent of his pecuniary interest therein.
3. These Common Stock Warrants are owned of record by Borlaug Limited, which is a consulting firm. Dr. Micallef is a controlling director of Borlaug Limited and has voting and dispositive control over the Common shares issuable to Borlaug Limited upon the conversion of these Warrants. However, Dr. Micallef disclaims beneficial ownership of these Options and Warrants except to the extent of his pecuniary interest therein.
/s/ Jacob Vincent Micallef 08/28/2015
** 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 5 (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.
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