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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative 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) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Convertible Promissory Note | $ 0.15 | 10/31/2011 | A | $ 58,823.53 | (1) | 10/31/2012 | Common Stock | 392,157 | (2) | $ 58,823.53 | I | See Footnote (3) | |||
Common Stock Warrants (right to buy) | $ 0.15 | 10/31/2011 | A | 196,078 | (1) | 10/31/2014 | Common Stock | 196,078 | (2) | 196,078 | I | See Footnote (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Rosenblum Mark J C/O ADVAXIS, INC., 305 COLLEGE ROAD EAST PRINCETON, NJ 08540 |
CFO, Senior VP & Secretary |
/s/ Mark J. Rosenblum | 11/02/2011 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(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). |
(1) | Immediately. |
(2) | Pursuant to that certain Note Purchase Agreement, dated as of October 28, 2011, by and among Advaxis, Inc. (the "Company") and certain accredited investors, including Mr. Rosenblum, the Company issued $58,823.53 of its convertible promissory notes (the "Notes") to Mr. Rosenblum for a purchase price of $50,000.00. Additionally, Mr. Rosenblum received a warrant to purchase such number of shares of the Company's common stock equal to 50% of such number of shares of the Company's common stock issuable upon conversion of the Note at an exercise price of $0.15 per share. The Notes purchased in the offering by Mr. Rosenblum were paid for in cash. |
(3) | Mr. Rosenblum owns these securities indirectly through the Mark J. Rosenblum IRA. |