- Statement of Changes in Beneficial Ownership (4)
03 Janvier 2013 - 12:10AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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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1. Name and Address of Reporting Person
*
GETLIN LAWRENCE W
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2. Issuer Name
and
Ticker or Trading Symbol
ProUroCare Medical Inc.
[
PUMD
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
2690 PHEASANT RD
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3. Date of Earliest Transaction
(MM/DD/YYYY)
12/28/2012
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(Street)
EXCELSIOR, MN 55331
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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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)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common stock, $0.00001 par value
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12/28/2012
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A
(4)
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8594
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A
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$0.64
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59772
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D
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Common Stock, $0.00001 par value
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12/28/2012
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M
(3)
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5243
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A
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$1.10
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65015
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D
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Common Stock, $0.00001 par value
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1/2/2013
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A
(5)
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20000
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A
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$0.64
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85015
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Stock Options
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$0.92
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(1)
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6/27/2018
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Common Stock, $0.00001 par value
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2265
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2265
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D
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Convertible notes
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$1.30
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(1)
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9/15/2013
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Common Stock, $0.00001 par value
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19231
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$25000
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D
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Stock Options
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$0.87
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(1)
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8/9/2018
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Common stock, $0.00001 par value
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28736
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28736
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D
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Stock Options
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$0.60
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(2)
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8/9/2019
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Common stock, $0.00001 par value
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25000
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25000
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D
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Convertible Note
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$1.10
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12/28/2012
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M
(3)
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5243
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(3)
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12/28/2012
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Common stock, $0.00001 par value
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5243
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$1
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$0
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D
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Explanation of Responses:
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(
1)
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Currently exercisable.
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(
2)
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Annual option award pursuant to the Issuer's compensation policy for Directors upon their re-election to the Board of Directors. The seven-year options vest ratably over 12 months.
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(
3)
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On December 28, 2012, the reporting person converted a convertible promissory note in the principal amount of $5,200, along with accrued interest thereon of $568, into common shares pursuant to the terms of the note. The transaction was approved by the Company's Board of Directors and is exempt under section 16b-3(d).
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(
4)
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Shares issued to directors in payment of directors' fees earned during the period from July 1, 2012 and December 31, 2012, in lieu of cash. The Issuer's Board of Directors specifically approved the transaction as exempt from the requirements of Section 16b as provided by Rule 16b-3(d).
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(
5)
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On January 2, 2013, the issuer issued 20,000 shares to the reporting person in lieu of cash for $12,800 of consulting fees due to the reporting person. The issuer's Board of Directors specifically approved the transaction as exempt from the requirements of Section 16b as provided by Rules 16b-3(d).
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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GETLIN LAWRENCE W
2690 PHEASANT RD
EXCELSIOR, MN 55331
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X
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Signatures
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Richard B. Thon by power of attorney
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1/2/2013
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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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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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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