Filing Details

Accession Number:
0001134619-11-000001
Form Type:
4
Zero Holdings:
No
Publication Time:
2011-01-06 16:09:15
Reporting Period:
2010-01-13
Filing Date:
2011-01-06
Accepted Time:
2011-01-06 16:09:15
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1446159 Biodrain Medical Inc. BIOR Orthopedic, Prosthetic & Surgical Appliances & Supplies (3842) 331007393
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1134619 E James Dauwalter Biodrain Medical Inc.
2060 Centre Pointe Blvd., Suite 7
Mendota Heights MN 55120
Yes No No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Convertible Note Due 2012 Acquisiton 2010-01-13 0 $0.00 0 No 4 P Direct
Common Stock Acquisiton 2010-05-27 89,143 $0.00 910,572 No 4 A Direct
Common Stock Acquisiton 2010-11-16 75,000 $0.00 985,572 No 4 A Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Direct
No 4 A Direct
No 4 A Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Options Acquisiton 2010-11-16 325,000 $0.00 325,000 $0.15
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
325,000 2010-11-16 2020-11-16 No 4 A Indirect
Footnotes
  1. This security was issued with a $50,000 principal amount by the Issuer in exchange for $50,000 in cash consideration. The conversion price is not fixed and floats based on the market price on the underlying common stock - specifically, the security converts at 50% of the average closing price of the Issuer's common stock during the 10-day period prior to conversion.
  2. The issuer granted these securities to the reporting person as a penalty for its failure to cause timely effectiveness of a registration statement on Form S-1.
  3. This stock award vests 100% upon the earlier of a change in control, average 30 day trading volume of 50,000 shares, or 6 consecutive quarters of not less than $150,000 in net income recognized by the issuer. If none of these events occur within 10 years of the grant date, then the stock is forfeited.
  4. This security was granted to David Dauwalter, the adult son of the reporting person and an employee of the Issuer. The reporting person disavows any beneficial interest in the security and underlying securities.