3: Initial statement of beneficial ownership of securities
Published on July 15, 2013
FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIESFiled 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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/18/2013 |
3. Issuer Name and Ticker or Trading Symbol
AETHLON MEDICAL INC [ AEMD ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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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) |
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Common Stock | 8,750,000 | D |
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) | ||
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Common Stock Purchase Warrants | 03/29/2012 | 03/29/2019 | Common Stock | 937,500 | 0.125 | D | |
Common Stock Purchase Warrants | 06/19/2012 | 06/19/2019 | Common Stock | 1,111,111 | 0.108 | D | |
Common Stock Purchase Warrants | 08/29/2012 | 08/29/2019 | Common Stock | 534,723 | 0.12 | D | |
Common Stock Purchase Warrants | 11/12/2012 | 11/12/2019 | Common Stock | 666,667 | 0.093 | D | |
Common Stock Purchase Warrants | 02/11/2013 | 02/11/2020 | Common Stock | 333,333 | 0.096 | D | |
Common Stock Purchase Warrants | 03/14/2013 | 03/14/2020 | Common Stock | 333,333 | 0.115 | D | |
Common Stock Purchase Warrants | 06/14/2013 | 06/14/2020 | Common Stock | 333,333 | 0.121 | D | |
10% Convertible Note | (1) | 10/09/2013(2) | Common Stock | 3,465,909 | 0.088 | D |
Explanation of Responses: |
1. Unpaid principal and accrued interest on the note are convertible at Dr. Shah's option into common stock only if the note is not repaid by October 9, 2013. In that event, unpaid principal and accrued interest may be converted into common stock at $0.088/share. In addition, upon conversion of the note, Dr. Shah would receive warrants to purchase that number of shares of common stock equal to 50% of the amount of principal and interest being converted divided by $0.088, with such warrants being exercisable at a price of $0.132/share. |
2. Maturity date. |
/s/ Chetan S. Shah, M.D. | 07/12/2013 | |
** 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.
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 Number.