Initial Statement of Beneficial Ownership (3)
June 02 2014 - 5:47PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
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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
*
Rowley David
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2. Date of Event Requiring Statement (MM/DD/YYYY)
6/1/2014
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3. Issuer Name
and
Ticker or Trading Symbol
Pharmagen, Inc. [PHRX]
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(Last)
(First)
(Middle)
9337 FRASER AVENUE
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4. 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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(Street)
SILVER SPRING, MD 20910
(City)
(State)
(Zip)
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5. 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 Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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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. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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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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Series C Convertible Preferred Stock
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(1)
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(2)
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Common Stock
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(3)
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(3)
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D
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Explanation of Responses:
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(
1)
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The shares of Series C Convertible Preferred Stock are convertible into shares of Pharmagen, Inc.'s common stock at any time.
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(
2)
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Shares of Series C Convertible Preferred Stock do not have an expiration date.
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(
3)
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On a fixed conversion basis, the holders of all 500,000 shares of the Series C Convertible Preferred Stock can acquire, upon conversion, 15% of the then outstanding shares of common stock of Pharmagen, Inc. Mr. Rowley's shares therefore entitle him to convert into 0.0075% of the common stock on a fixed conversion basis. On a variable conversion basis, the Series C Convertible Preferred Stock is convertible into common stock of Pharmagen, Inc., at 33.33% of the lowest five closing bid prices of Pharmagen, Inc.'s common stock during the ten trading days prior to conversion. The holder of the Series C Convertible Preferred Stock has sole authority to decide which conversion formula (fixed versus variable) will be used at the time of each applicable conversion. In no event can any single shareholder convert the Series C Convertible Preferred Stock if it will result in their ownership exceeding 9.99% of Pharmagen, Inc.'s then issued and outstanding shares of common stock.
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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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Rowley David
9337 FRASER AVENUE
SILVER SPRING, MD 20910
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X
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Signatures
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/s/ David Rowley
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6/2/2014
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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 5(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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