0001179110-15-012643.txt : 20150826 0001179110-15-012643.hdr.sgml : 20150826 20150826122721 ACCESSION NUMBER: 0001179110-15-012643 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150806 FILED AS OF DATE: 20150826 DATE AS OF CHANGE: 20150826 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ACTIVECARE, INC. CENTRAL INDEX KEY: 0001429896 STANDARD INDUSTRIAL CLASSIFICATION: COMMUNICATIONS EQUIPMENT, NEC [3669] IRS NUMBER: 870578125 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 1365 WEST BUSINESS PARK DRIVE CITY: OREM STATE: UT ZIP: 84058 BUSINESS PHONE: 877-219-6050 MAIL ADDRESS: STREET 1: 1365 WEST BUSINESS PARK DRIVE CITY: OREM STATE: UT ZIP: 84058 FORMER COMPANY: FORMER CONFORMED NAME: Volu-Sol Reagents CORP DATE OF NAME CHANGE: 20080317 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADP MANAGEMENT CORP CENTRAL INDEX KEY: 0001120338 STATE OF INCORPORATION: UT FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-53570 FILM NUMBER: 151075235 BUSINESS ADDRESS: STREET 1: 1401 N HIGHWAY 89 STREET 2: SUITE 240 CITY: FARMINGTON STATE: UT ZIP: 84025 BUSINESS PHONE: 801-451-5742 MAIL ADDRESS: STREET 1: 1401 N HIGHWAY 89 STREET 2: SUITE 240 CITY: FARMINGTON STATE: UT ZIP: 84025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DERRICK DAVID G CENTRAL INDEX KEY: 0000938421 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-53570 FILM NUMBER: 151075236 MAIL ADDRESS: STREET 1: 1401 NORTH HIGHWAY 89, SUITE 240 CITY: FARMINGTON STATE: UT ZIP: 84025 4 1 edgar.xml FORM 4 - X0306 4 2015-08-06 0 0001429896 ACTIVECARE, INC. ACAR 0000938421 DERRICK DAVID G 1401 NORTH 1075 WEST, SUITE 240 FARMINGTON UT 84025 0 0 1 0 0001120338 ADP MANAGEMENT CORP 1401 N. 1075 W., STE. 240 FARMINGTON UT 84025 0 0 1 0 Common Stock 2015-08-06 4 J 0 750000 A 10107579 I By ADP Management Corporation Common Stock 2015-08-06 4 J 0 737132 D 9370447 I By ADP Management Corporation Common Stock 4750 I By Purizer Corporation Common Stock 1212500 I By Schwartz Group, LLC Common Stock 37006 D The shares of common stock were issued to David Derrick as a severance payment and in consideration of Mr. Derrick's willingness to continue to guaranty certain obligations of issuer; however, at Mr. Derrick's request, such shares were issued in the name of ADP Management Corporation. ADP Management Corporation is owned and controlled, in part, by David Derrick. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. The shares of common stock were transferred to third parties pursuant to purchase agreements which contained contingent future obligations to transfer additional shares of common stock to such third parties for no additional consideration. Purizer Corporation is owned and controlled, in part, by David Derrick. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. Schwartz Group, LLC is owned, in part, by ADP Management Corporation. The Reporting Persons disclaim beneficial ownership of these securities except to the extent of their respective pecuniary interests therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. David G. Derrick 2015-08-26 By: David G. Derrick, Secretary and Treasurer 2015-08-26