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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
GIRSCHWEILER THOMAS C/O BIOLIFE SOLUTIONS, INC. 3303 MONTE VILLA PARKWAY BOTHELL, WA 98021 |
X | X |
/s/ Thomas Girschweiler | 04/29/2013 | |
**Signature of Reporting Person | Date |
* | 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). |
(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. |