SEC FORM 4/A SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Schwartz Carl I.

(Last) (First) (Middle)
3750 LAS VEGAS BLVD. SOUTH
APT. 4303

(Street)
LAS VEGAS NV 89158

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Predictive Oncology Inc. [ POAI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
3. Date of Earliest Transaction (Month/Day/Year)
07/01/2019
4. If Amendment, Date of Original Filed (Month/Day/Year)
08/15/2019
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 244,298 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Third Amended and Restated Common Stock Purchase Warrant(1)(5) $0.704 07/01/2019 J(6) 11,506 07/01/2019 02/06/2024 Common Stock 11,506 (6) 1,171,405 D
Third Amended and Restated Common Stock Purchase Warrant(1) $0.704 08/01/2019 J(2) 11,506 08/01/2019 02/06/2024 Common Stock 11,506 (2) 1,182,911(5) D
Stock Option(3) $0.79 07/01/2019 A 42,194 07/01/2019 06/30/2029 Common Stock 42,194 $0 42,194(5) D
Stock Option(4) $0.65 08/01/2019 A 51,282 08/01/2019 07/31/2029 Common Stock 51,282 $0 51,282(5) D
Explanation of Responses:
1. On May 21, 2019 the Issuer and the Reporting Person executed the Third Amended and Restated Common Stock Purchase Warrant (the "Warrant") which amends and restates that certain warrant issued on November 30, 2018 (the "Original Warrant"). It included a second investment of an additional $950,000, and a third investment of an additional $300,000 resulting in a total investment of $1,620,000. (See Form 4 filed on December 10, 2018 for details of the Original Warrant.) In addition to the shares reported, the Warrant provides for additional shares to be added to the Warrant beginning on February 1, 2019 and the first day of each calendar month thereafter, equal to one-half percent (1/2%) of the outstanding principal balance of the Note on such date, divided by $0.704.
2. Represents additional shares added to the Warrant as of 8/1/2019 as a result of the formula in the Warrant.
3. Pursuant to the Stock Option Agreement dated July 1, 2019, between the Issuer and the Reporting Person.
4. Pursuant to the Stock Option Agreement dated August 1, 2019, between the Issuer and the Reporting Person.
5. This Form 4 is being amended to include a missed transaction and to correct certain totals.
6. Represents additional shares added to the Warrant as of 7/1/2019 as a result of the formula in the Warrant.
/s/ Carl I. Schwartz, DDS 09/18/2019
** 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 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).
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