| 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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
INTELLIGENT BIO SOLUTIONS INC. [ INBS ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 12/22/2022 | ||||||||||||||||||||||||||
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4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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| 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 - Prior Balance | 125,228 | D | ||||||||
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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| 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 | ||||||||
| Series D Convertible Preferred Stock | (1) | 12/22/2022(2) | P | 15,992 | (1) | (1) | Common Stock | 15,993(2) | $0.87 | 15,993 | I | Held by Anest Holdings(3) | |||
| Common Stock Purchase Warrant | $0.29(4) | 12/22/2022(2) | P | 47,979 | 06/23/2023 | 06/23/2028 | Common Stock | 47,979(2) | $0.1267 | 47,979 | I | Held by Anest Holdings(3) | |||
| Explanation of Responses: |
| 1. The Series D Convertible Preferred Stock is initially convertible into three shares of common stock of the Issuer. The conversion ratio is subject to adjustment. Following the Trigger Date (defined below), each share of Series D Convertible Preferred Stock is convertible at any time at the option of the holder and without payment of further consideration. The Series D Convertible Preferred Stock has no expiration date. As used herein, "Trigger Date" means the earlier to occur of (i) the date that the last of (a) the Issuer's shareholders approve the conversion of the Series D Convertible Preferred Stock or (b) the Issuer's shareholders approve a reverse split of the Issuers's common stock, or (ii) the date which is 60 days following the date on which the Common Stock is no longer listed on the Nasdaq Stock Market, the New York Stock Exchange or the NYSE American. |
| 2. On December 22, 2022, Anest Holdings Pty Ltd, as trustee of ATF S&T Sakiris Superannuation Fund, purchased 15,993 units from the Issuer in a private placement. Each unit consists of one share of Series D Convertible Preferred Stock (valued at $0.87 each) and three common stock purchase warrants (collectively valued at $0.35, or $0.1267 each). The purchase price of each unit was $1.25 per unit. |
| 3. These securities are held by Anest Holdings Pty Ltd, as trustee of ATF S&T Sakiris Superannuation Fund, of which Mr. Sakiris is a Director. |
| 4. Subject to adjustment. |
| /s/ Spiro Sakiris | 12/23/2022 | |
| ** 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). | ||
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
| 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 Number. | ||