4//SEC Filing
KUBOTA TOM 4
Accession 0001185185-23-001023
CIK 0001138476other
Filed
Oct 2, 8:00 PM ET
Accepted
Oct 3, 12:45 PM ET
Size
6.4 KB
Accession
0001185185-23-001023
Insider Transaction Report
Form 4
KUBOTA TOM
DirectorPresident10% Owner
Transactions
- Purchase
Common
2023-10-02$0.80/sh+55,000$44,000→ 8,351,647 total
Holdings
- 16,000
Series A Preferred
Exercise: $0.00→ Common Stock (16,000 underlying)
Footnotes (2)
- [F1]The Reporting Person holds the shares through the Tom Kubota Revocable Trust of 2013 (the "Trust"). The Reporting Person is the sole Trustee of the Trust. As such, the Reporting Person may be deemed to have voting and/or investment power over the shares held by the Trust and therefore may be deemed to be the beneficial owner of those shares.
- [F2]The Series A Preferred Stock converts into Common Stock of the Issuer on a 1:1 basis at any time at the election of the Reporting Person and has no expiration date.
Documents
Issuer
PACIFIC HEALTH CARE ORGANIZATION INC
CIK 0001138476
Entity typeother
Related Parties
1- filerCIK 0001271519
Filing Metadata
- Form type
- 4
- Filed
- Oct 2, 8:00 PM ET
- Accepted
- Oct 3, 12:45 PM ET
- Size
- 6.4 KB