Sec Form 4 Filing - Busch Jeffrey @ THERALINK TECHNOLOGIES, INC. - 2022-11-29

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Busch Jeffrey
2. Issuer Name and Ticker or Trading Symbol
THERALINK TECHNOLOGIES, INC. [ THER]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
15000 W. 6TH AVE., #400
3. Date of Earliest Transaction (MM/DD/YY)
11/29/2022
(Street)
GOLDEN, CO80401
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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 of Derivative Security: 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
10% O.I.D. Senior Secured Convertible Debenture $ 0.003 ( 1 ) 11/29/2022 J( 2 ) 11/29/2023( 3 ) 11/29/2023( 3 ) Common Stock 103,161,667 ( 4 ) $ 0 ( 2 ) $ 309,485 D
10% O.I.D. Senior Secured Convertible Debenture $ 0.003 ( 1 ) 11/29/2022 A 11/29/2023( 3 ) 11/29/2023( 3 ) Common Stock 18,333,333 ( 4 ) $ 50,000 $ 55,000 D
10% O.I.D. Senior Secured Convertible Debenture $ 0.003 ( 1 ) 04/22/2023 A 11/29/2023( 3 ) 11/29/2023( 3 ) Common Stock 51,700,000 $ 141,000 $ 155,100 D
Common Stock Purchase Warrant $ 0.003 ( 1 ) 11/29/2022 J( 2 ) 88,424,286 11/29/2023( 3 ) 05/29/2029( 5 ) Common Stock 88,424,286 $ 0 ( 2 ) 88,424,286 D
Common Stock Purchase Warrant $ 0.003 ( 1 ) 11/29/2022 A( 6 ) 15,714,286 11/29/2023( 3 ) 05/29/2029( 5 ) Common Stock 15,714,286 $ 0 ( 6 ) 15,714,286 D
Common Stock Purchase Warrant $ 0.003 ( 1 ) 04/22/2023 A( 7 ) 44,314,286 11/29/2023 05/29/2029 Common Stock 44,314,286 $ 0 ( 7 ) 44,314,286 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Busch Jeffrey
15000 W. 6TH AVE., #400
GOLDEN, CO80401
X
Signatures
/s/ Jeffrey Busch 02/02/2024
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Assumes a fixed conversion price of $0.003, but such conversion price is subject to adjustment as set forth in the debenture and warrant, respectively.
( 2 )The Reporting Person was issued a 10% Original Issue Discount ("O.I.D.") Senior Secured Convertible Debenture in the principal amount of $309,485 and 88,424,286 warrants in exchange for a demand promissory note in the principal amount of $250,000 previously issued to the Reporting Person.
( 3 )The debentures and warrants acquired by the Reporting Person are subject to mandatory conversion upon the occurrence of certain events, as outlined in the debentures and warrants. The original maturity date of the debentures was subsequently extended to February 29, 2024.
( 4 )Excludes shares issuable at the election of the Reporting Person upon conversion of accrued interest (both past and future) into shares of common stock.
( 5 )Expiration Date in the event a Qualified Offering is not consummated prior to the maturity date of the debentures the Warrants are issued in connection with.
( 6 )The Reporting Person purchased a 10% O.I.D. Senior Secured Convertible Debenture in the principal amount of $55,000 and 15,714,286 Warrants for an aggregate purchase price of $50,000 in a private placement offering that closed on November 29, 2022.
( 7 )The Reporting Person purchased a 10% O.I.D. Senior Secured Convertible Debenture in the principal amount of $155,100 and 44,314,286 Warrants for an aggregate purchase price of $141,000 in a private placement offering that closed on April 22, 2023.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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