Brooks Jack E 4

4 · ASSURED PHARMACY, INC. · Filed Feb 7, 2013

Form 4

Period: 2013-02-05

10% Owner

Transactions

Other
16% Convertible Debentures
2013-02-05+16,000→ 56,000 total(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.90From: 2011-11-30Exp: 2014-05-30→ Common Stock (16,000 underlying)
Other
Series B Preferred Stock
2013-02-05+333,600→ 667,200 total(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.90→ Common Stock (333,600 underlying)
Purchase
Common Stock
2013-02-05+769,230→ 865,266 total(indirect: By Pinewood Trading Fund, LP)
Other
Common Stock Warrants
2013-02-05+32,640→ 80,640 total(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.90From: 2011-11-30Exp: 2016-11-30→ Common Stock (32,640 underlying)
Purchase
Common Stock Warrants
2013-02-05+769,230→ 769,230 total(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.90From: 2013-02-05Exp: 2016-02-05→ Common Stock (769,230 underlying)

Holdings

Footnotes (5)

[F1]The reported securities are included within Units purchased by the reporting person for an aggregate of $500,000 for the Units. The Units consist of 769,230 shares of Common Stock and 769,230 warrants exercisable for shares of Common Stock.
[F2]The reported securities are owned directly by Pinewood Trading Fund, L.P., and indirectly by Sagewood, LLC, as General Partner of Pinewood Trading Fund, L.P., and Jack E. Brooks, as Manager of Sagewood, LLC. Sagewood, LLC and Jack E. Brooks disclaim beneficial ownership of the reported securities except to the extent of their pecuniary interest therein.
[F3]The reported securities are owned directly and indirectly by Jack E. Brooks.
[F4]The shares were acquired as a result of the resetting of the conversion price of the securities previously reported, resulting from the triggering of the anti-dilution adjustments contained in the securities.
[F5]Series B Preferred Stock is convertible at any time at the reporting person's election, and has no expiration date.

Documents

1 file