SOURCE: Oncologix Tech, Inc.
8/27/2012 12:28:00 PM

Oncologix Tech, Inc. - 4

FORM 4

Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

Print or Type Responses


UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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


1.        Name and Address of Reporting Person*

 

Silverman               Anthony

2.        Issuer Name and Ticker or Trading Symbol

 

Oncologix Tech, Inc. (OCLG)

5.              Relationship of Reporting Person(s) to Issuer

X

(Check all applicable)

Director

Officer (give

title below)

CEO and President

    10% Owner

X

Other (specify

(Last)              (First)              (Middle)

 

  P.O. Box 8832

3.              Date of Earliest

Transcaction Required

to be Reported

(Month/Day/Year)

 

 

08/27/12

4. If Amendment,

Date Original

Filed(Month/Day/Year)

 

below)

 

 

 

6.              Individual or Joint /Group Filing (Check all applicable line)

  X Form filed by One Reporting Person

  __Form filed by More Than One Reporting Person

 

filed by One Reporting

filed by More than One

Filing (Check Applicable

Person

Reporting Person

Line)

(Street)

 

  Grand Rapids                  MI            49518-8832

(City)              (State)              (Zip)

Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

 

1. Title of Security

(Instr. 3)

2. Trans-

action

Date

(Month/

Day/

Year)

2A. Deemed

Execution

Date, if

any

(Month/

Day/Year)

3. Trans-

action

Code

(Instr.

8)

4.              Securities Acquired (A) or

or Disposed of (D)(Instr. 3, 4 and 5)

 

 

5.

Amount of

Securities

Beneficially

Owned

Following

Reported

Transaction (s)

(Instr. 3 and 4)

6.

Owner-

ship

Form:

Direct

(D) or

Indirect

(I)

(Instr. 4)

7.

Nature of

Indirect

Beneficial

Owner‑

ship

(Instr. 4)

Code

V

Amount

(A) or

(D)

Price

Common Stock (1)

08/27/12

 

  A

 

2,276,182

  A

  $0.02

 

6,718,895

 

D (1)

 

 

Common Stock (1)

08/27/12

 

  G

 

2,276,182

  D

  $0.02

 

4,442,713

 

D (1)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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 4(b)(v).

Potential              persons              who              are              to              respond              to              the              collection              of

(Over)

information contained in this form are not required to respond

unless the form displays a currently valid OMB control number.

SEC 1474 (01-05)


FORM 4 (continued)              Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned ( e.g., puts, calls, warrants, options, convertible securities)

1.              Title of Derivative

Security

(Instr. 3)

2. Conver-

sion or

Exercise

Price of

Deri-

vative

Security

3. Trans-

action

Date

(Month/

Day/

Year)

3A.Deemed

Execution

Date, if

any

(Month/

Day/

Year)

4. Trans-

action

Code

(Instr

8)

 

 

5. Number of Derative

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)

Of

8. Price

of

Deriv-

ative

Secur-

ity

(Instr.

5)

9. Number

of deriv-

ative

Secur-

ities

Bene-

ficially

Owned

At end of Month

(Instr.4)

10.Owner-

ship

Form of

Deriv-

ative

Security:

Direct

(D) or

Indirect

(I)

(Instr. 4)

11.Nature

of

Indirect

Benefi‑

cial

Owner‑

ship

(Instr. 4)

Date

Exer-

cisable

Expira-

tion

Date

Title

Amount or

Number of

Shares

Code

V

(A)

(D)

Convertible Note (1)

$0.02

08/27/12

 

C

 

2,250,000

 

08/23/12

11/21/12

Common Stock

2,250,000

$0.02

3,500

D (2)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation of Responses:

(1)     On August 24, 2012, Mr. Silverman elected to convert his $45,000 promissory note plus accrued interest into 2,276,182 shares of the Company’s common stock.  As part of the conversion, Mr. Silverman gifted 2,276,182 shares of the Company’s common stock to non-affiliates.  These shares were issued August 28, 2012 and the note was convertible at $0.02 per share.

(2)     Mr. Silverman holds a direct interest in 4,442,713 shares of common stock, a direct interest in 3,500 stock options to purchase common stock.

 

                                                                                                                         /s/Anthony Silverman                         08/28/12   

** 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.

 

Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.

**Signature of Reporting Person              Date