Statement of Changes in Beneficial Ownership (4)
06 June 2018 - 9:02AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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Filed 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
*
STUCKERT JAMES W
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2. Issuer Name
and
Ticker or Trading Symbol
WOUND MANAGEMENT TECHNOLOGIES, INC.
[
wndm
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
16633 DALLAS PARKWAY, SUITE 250
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3. Date of Earliest Transaction
(MM/DD/YYYY)
2/19/2018
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(Street)
ADDISON, TX 75001
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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2/19/2018
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J
(1)
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11325678
(1)
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A
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$0.07
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22057433
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I
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By James W. Stuckert Revocable Trust
(4)
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Common Stock
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2/19/2018
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J
(2)
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13037070
(2)
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A
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$0.07
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65094503
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I
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By James W. Stuckert Revocable Trust
(4)
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Common Stock
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2/19/2018
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J
(3)
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3965400
(3)
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A
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$0.07
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5365400
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I
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By Diane V. Stuckert Revocable Trust
(5)
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Common Stock
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1500000
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I
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By James W. Stuckert Family Trust
(6)
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Common Stock
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835586
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I
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Ten Grand Ltd.
(7)
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Series C Preferred Stock
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(2)
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2/19/2018
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J
(2)
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36384
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2/10/2016
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(2)
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Common Stock
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43037070
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(2)
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0
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I
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By James W. Stuckert Revocable Trust
(4)
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Series C Preferred Stock
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(3)
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2/19/2018
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J
(3)
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3572
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12/21/2015
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(3)
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Common Stock
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3965400
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(3)
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0
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I
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By Diane V. Stuckert Revocable Trust
(5)
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Explanation of Responses:
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(1)
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On February 19, 2018, the James W. Stuckert Revocable Trust converted all principal and interest under that certain promissory note, dated as of June 15, 2015, in the principal amount of $600,000, into 11,325,678 shares of the Company's Common Stock.
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(2)
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On February 19, 2018, the James W. Stuckert Revocable Trust converted 36,384 shares of the Company's Series C Convertible Preferred Stock, together with all accrued but unpaid dividends thereon, into a total of 43,037,070 shares of the Company's Common Stock.
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(3)
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On February 19, 2018, the Diane V. Stuckert Revocable Trust converted 3,572 shares of the Company's Series C Convertible Preferred Stock, together with all accrued but unpaid dividends thereon, into a total of 3,965,400 shares of the Company's Common Stock.
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(4)
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The reporting person is the trustee of the trust.
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(5)
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The reporting person's spouse is trustee of the trust. The reporting person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
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(6)
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The reporting person's spouse is trustee of the trust. The reporting person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
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(7)
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The reporting person serves as the general partner of the partnership.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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STUCKERT JAMES W
16633 DALLAS PARKWAY
SUITE 250
ADDISON, TX 75001
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X
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X
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Signatures
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/s/ James Stuckert
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6/5/2018
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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