Amended Statement of Beneficial Ownership (sc 13d/a)
January 09 2019 - 2:12PM
Edgar (US Regulatory)
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13D
Under the Securities Exchange Act of 1934
(Amendment No. 8)*
NEXEON MEDSYSTEMS INC
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(Name of Issuer)
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Common Stock, $0.001 Par Value
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(Title of Class of Securities)
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65342G 203
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(CUSIP Number)
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William Rosellini
1910 Pacific Avenue
Suite 20000
Dallas, Texas 75201
Telephone: (844) 919-9990
(Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications)
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January 8, 2019
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(Date of Event which Requires Filing of this Statement)
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If the filing person has previously filed
a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because
of §§ 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box.
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Note:
Schedules filed
in paper format shall include a signed original and five copies of the schedule, including all exhibits. See §
240.13d-7 for other parties to whom copies are to be sent.
*The remainder of this cover page shall
be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for
any subsequent amendment containing information which would alter disclosures provided in a prior cover page.
The information required on the remainder
of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of
1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions
of the Act (however, see the Notes).
1
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NAMES OF REPORTING PERSONS
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
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William Rosellini
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2
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)
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(a)
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(b)
☐
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3
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SEC USE ONLY
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4
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SOURCE OF FUNDS (See Instructions)
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PF
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5
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CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(D) OR 2(E)
☐
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6
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CITIZENSHIP OR PLACE OF ORGANIZATION
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United States
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NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON
WITH
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7
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SOLE VOTING POWER:
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52,685
(1)
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8
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SHARED VOTING POWER:
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193,674
(2)
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9
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SOLE DISPOSITIVE POWER:
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52,685
(1)
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10
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SHARED DISPOSITIVE POWER:
193,674
(2)
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11
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
246,359
(1) (2)
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12
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (See Instructions)
☐
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13
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)11.87%
(3)
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14
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TYPE OF REPORTING PERSON (See Instructions)
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IN
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(1)
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Represents options to purchase 52,685 shares of common stock that are exercisable within 60 days. All beneficial ownership numbers and percentages exclude options to purchase 29,459 shares of common stock granted to Mr. William Rosellini on February 28, 2018 by the Issuer which would not vest within 60 days.
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(2)
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Represents 5,932 shares of common stock held by Mr. Rosellini’s wife and 187,742 shares of common stock held by Rosellini Scientific Holdings, LLC of which Mr. William Rosellini is the sole member, and, in such capacity, has voting and dispositive power over the securities held by this entity.
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(3)
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Percentage ownership is determined based on shares owned together with securities exercisable or convertible into shares of common stock within 60 days of the date of this report, for each stockholder. Beneficial ownership is determined in accordance with the rules of the SEC and generally includes voting or investment power with respect to securities. Furthermore, the percentages set forth in this column are based on 2,023,646 shares of the Issuer’s common stock issued and outstanding as of January 9, 2019.
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1
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NAMES OF REPORTING PERSONS
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
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Rosellini Scientific Holdings, LLC
Tax ID: 3206772349
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2
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)
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(a)
☐
(b)
☐
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3
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SEC USE ONLY
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4
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SOURCE OF FUNDS (See Instructions)
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WC
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5
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CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(D) OR 2(E)
☐
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6
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CITIZENSHIP OR PLACE OF ORGANIZATION
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United States
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NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON
WITH
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7
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SOLE VOTING POWER:
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0
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8
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SHARED VOTING POWER:
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187,742
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9
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SOLE DISPOSITIVE POWER:
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0
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10
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SHARED DISPOSITIVE POWER:
187,742
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11
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
187,742
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12
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (See Instructions)
☐
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13
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
9.28%
(1)
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14
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TYPE OF REPORTING PERSON (See Instructions)
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OO
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(1)
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The percentages set forth in this column are based on 2,023,646 shares of the Issuer’s common stock issued and outstanding as of January 9, 2019.
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Item 1.
Security and
Issuer
The title and class of equity securities
to which this Schedule 13D relates is the common stock, $0.001 par value, of Nexeon Medsystems Inc, a Nevada corporation (the “Issuer”).
The principal offices of the Issuer are located at 1910 Pacific Avenue, Suite 20000, Dallas, Texas 75201.
Item 2.
Identity and
Background
(a) This statement is being filed by William
Rosellini and Rosellini Scientific Holdings, LLC (collectively, the “Reporting Persons”).
(b) Mr. Rosellini’s business address
is 77 Calle Arrecife, Dorado, Puerto Rico, 00646. Rosellini Scientific Holdings, LLC’s business address is corner of Jews
and Marion, Charleston, Nevis.
(c) Mr. Rosellini is currently employed
as Chief Executive Officer of the Issuer and Chairman of the Board of Directors of the Issuer. The Issuer has a business address
at 1910 Pacific Avenue, Suite 20000, Dallas, Texas 75201 and is primarily engaged in the business of developing, manufacturing
and commercializing neurostimulation technology for the treatment of various neurological disorders through electrical stimulation
of neural tissues.
(d) During the last five years, the Reporting
Persons have not been convicted in a criminal proceeding (excluding traffic violations or similar misdemeanors).
(e) During the last five years, the Reporting
Persons have not been a party to a civil proceeding of a judicial or administrative body of competent jurisdiction and as a result
thereof were or are subject to a judgment, decree or final order enjoining future violations of, or prohibiting or mandating activities
subject to, federal or state securities laws or finding any violation with respect to such laws.
(f) Mr. William Rosellini is a citizen
of the United States. Rosellini Scientific Holdings, LLC was formed in the Country of Nevis.
Item 3.
Source and
Amount of Funds or Other Considerations
All shares were purchased with the Reporting
Persons’ personal funds or working capital.
Item 4.
Purpose of
Transaction
All of the Issuer’s securities owned
by the Reporting Persons have been acquired for investment purposes only. Except as set forth above and herein, the Reporting Persons
have no present plans or proposals that relate to or would result in any of the actions required to be described in subsections
(a) through (j) of Item 4 of Schedule 13D. The Reporting Persons may, at any time, review or reconsider their positions with respect
to the Issuer and formulate plans or proposals with respect to any of such matters, but has no present intention of doing so.
Item 5.
Interest in
Securities of the Issuer
(a)
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Mr. Rosellini beneficially owns 264,359 shares or 11.87% of the Issuer’s common stock, including (i) options to purchase 52,685 shares of common stock that are exercisable within 60 days, (ii) 5,932 shares held by Mr. Rosellini’s wife and (iii) 187,742 shares of common stock held by Rosellini Scientific Holdings, LLC of which Mr. William Rosellini is the sole member, and, in such capacity, has voting and dispositive power over the securities held by this entity.
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(b)
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Mr. Rosellini may be deemed to hold sole voting and dispositive power over 52,685
(1)
shares of common stock of the Issuer and shared voting and dispositive power over 193,674 shares of common stock of the Issuer.
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(c)
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On January 8, 2019, Rosellini Scientific Holdings, LLC respectively gifted 26,500 shares of common stock of the Issuer to Elizabeth Rosellini, 19,000 shares to Michael Rosellini, 35,000 shares to Rosellini Family Irrevocable Trust UA Dated 09/24/2018, and 402,785 shares to Rosellini Family Irrv Tr 2 (collectively, the “Transactions”). No cash consideration was paid in the Transactions. The Transactions took place in Dorado, Puerto Rico.
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(d)
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To the best knowledge of the Reporting Person, except as set forth in this Schedule 13D, no person other than the Reporting Person has the right to receive, or the power to direct the receipt of, dividends from, or the proceeds from the sale of the 243,680 shares of common stock reported in Item 5(a).
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(1)
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Includes (i) an incentive stock option grant to purchase up to 17,858 shares of the Common Stock (which represents the vested portion, including shares vesting within 60 days) of an incentive stock option to purchase up to 17,858 shares of Common Stock pursuant to the 2016 Plan, and (ii) a non-qualified stock option grant to purchase up to 34,827 shares of Common Stock (which represents the vested portion, including shares vesting within 60 days) of a non-qualified stock option to purchase up to 64,286 shares of Common Stock. All beneficial ownership numbers and percentages exclude options to purchase 29,459 shares of common stock granted to Mr. William Rosellini on February 28, 2018 by the Issuer which would not vest within 60 days.
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Item 6.
Contracts,
Arrangements, Understandings or Relationships with Respect to Securities of the Issuer
Other than as described herein, there are
no contracts, arrangements, understandings or relationships (legal or otherwise) between the Reporting Person and any other person
with respect to any securities.
Item 7. Material to Be Filed as
Exhibits
SIGNATURE
After reasonable inquiry
and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
Dated: January 9, 2019
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/s/
William Rosellini
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William Rosellini
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Dated: January 9, 2019
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Rosellini Scientific Holdings, LLC
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By:
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/s/
William Rosellini
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William Rosellini
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Sole Member
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