ASSURED PHARMACY, INC. 4

4 · ASSURED PHARMACY, INC. · Filed Aug 15, 2014

Insider Transaction Report

Form 4

Period: 2013-11-19

ASSURED PHARMACY, INC.APHY

Brooks Jack E

10% Owner

Transactions

Purchase
Series D Preferred Stock
2013-11-19+1,000→ 1,000 total(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.50→ Common Stock (2,000,000 underlying)
Other
Common Stock
2014-07-17+480,760→ 1,346,026 total(indirect: By Pinewood Trading Fund, LP)
Other
Series D Preferred Stock
2014-07-17+800→ 1,800 total(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.50→ Common Stock (1,600,000 underlying)
Purchase
Series A Common Stock Warrants
2013-11-19+1,000→ 1,000 total(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.50From: 2013-12-03Exp: 2018-12-03→ Common Stock (2,000,000 underlying)
Purchase
Series B Common Stock Warrants
2013-11-19+1,000→ 1,000 total(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.50From: 2013-12-03Exp: 2018-12-03→ Common Stock (2,000,000 underlying)

Holdings

Series B Preferred Stock
(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.90→ Common Stock (667,200 underlying)
667,200
Common Stock Warrants
(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.90From: 2011-11-30Exp: 2016-11-30→ Common Stock (80,640 underlying)
80,640
16% Convertible Debentures
(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.90From: 2011-11-30Exp: 2014-05-30→ Common Stock (56,000 underlying)
56,000
Common Stock Warrants
(indirect: By Pinewood Trading Fund, LP)
Exercise: $0.90From: 2013-02-05Exp: 2016-02-05→ Common Stock (769,230 underlying)
769,230
Common Stock
65,000
Common Stock
(indirect: By IRA)
8,987

Footnotes (8)

[F1]These shares were issued in satisfaction of a "make-whole" provision in a securities purchase agreement. See footnote 2.
[F2]The reported securities are included within Units acquired in a private placement pursuant to a securities purchase agreement, for an aggregate purchase price of $500,000 for the Units. The Units consist of shares of Common Stock and warrants exercisable for shares of Common Stock.
[F3]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.
[F4]The reported securities are owned directly and indirectly by Jack E. Brooks.
[F5]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.
[F6]Series B Preferred Stock and Series D Preferred Stock are convertible at any time at the reporting person's election, and have no expiration date.
[F7]The reported securities were acquired in a private placement pursuant to a securities purchase agreement, for an aggregate purchase price of $1,000,000.
[F8]These shares were issued in satisfaction of a "milestone adjustment" provision of a securities purchase agreement. See foonote 7.

Documents

1 file

4
doc1.xmlPrimary
FORM 4