Sec Form 5 Filing - KATZAROFF JAMES C @ VIVOS INC - 2017-12-31

Insider filing report for Changes in Beneficial Ownership
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FORM 5
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
KATZAROFF JAMES C
2. Issuer Name and Ticker or Trading Symbol
VIVOS INC [ RDGL]
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)
C/O VIVOS INC, 719 JADWIN AVENUE
3. Date of Earliest Transaction (MM/DD/YY)
12/31/2017
(Street)
RICHLAND, WA99352
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
Common Stock 02/02/2017 C 1,545,400 A $ 0.5 1,064,246 D
Common Stock 05/31/2017 A 600,000 A 600,540 I By Spouse
Common Stock 07/21/2017 A 1,500,000 A 1,064,246 D
Common Stock 03/30/2017 S 35,000 D $ 0.13 1,064,246 D
Common Stock 03/31/2017 S 10,000 D $ 0.14 1,064,246 D
Common Stock 04/07/2017 S 10,000 D $ 0.12 1,064,246 D
Common Stock 04/11/2017 S 30,000 D $ 0.13 1,064,246 D
Common Stock 04/17/2017 S 10,000 D $ 0.12 1,064,246 D
Common Stock 04/20/2017 S 10,000 D $ 0.12 1,064,246 D
Common Stock 04/28/2017 S 10,000 D $ 0.11 1,064,246 D
Common Stock 04/28/2017 S 5,000 D $ 0.11 1,064,246 D
Common Stock 05/01/2017 S 33,859 D $ 0.12 1,064,246 D
Common Stock 05/02/2017 S 20,000 D $ 0.11 1,064,246 D
Common Stock 05/04/2017 S 15,000 D $ 0.11 1,064,246 D
Common Stock 05/17/2017 S 10,000 D $ 0.1 1,064,246 D
Common Stock 05/23/2017 S 25,000 D $ 0.1 1,064,246 D
Common Stock 05/24/2017 S 10,000 D $ 0.12 1,064,246 D
Common Stock 06/06/2017 S 20,000 D $ 0.09 1,064,246 D
Common Stock 07/21/2017 S 25,000 D $ 0.08 1,064,246 D
Common Stock 07/24/2017 S 25,000 D $ 0.08 1,064,246 D
Common Stock 07/25/2017 S 20,000 D $ 0.08 1,064,246 D
Common Stock 08/07/2017 S 23,016 D $ 0.07 1,064,246 D
Common Stock 08/30/2017 S 11,882 D $ 0.07 1,064,246 D
Common Stock 09/05/2017 S 22,141 D $ 0.07 1,064,246 D
Common Stock 09/11/2017 S 22,000 D $ 0.07 1,064,246 D
Common Stock 09/15/2017 S 15,000 D $ 0.06 1,064,246 D
Common Stock 09/19/2017 S 10,000 D $ 0.06 1,064,246 D
Common Stock 09/20/2017 S 15,000 D $ 0.07 1,064,246 D
Common Stock 09/29/2017 S 25,000 D $ 0.08 1,064,246 D
Common Stock 10/09/2017 S 15,000 D $ 0.08 1,064,246 ( 3 ) D
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
Series A Convertible Preferred Stock $ 0.5 02/02/2017 C 154,540 04/15/2016 ( 4 ) Common Stock 1,545,400 $ 0 150,000 D
Series A Convertible Preferred Stock $ 0.5 05/31/2017 A 10,000 04/15/2016 ( 4 ) Common Stock 100,000 ( 1 ) 10,000 I By Spouse
Series A Convertible Preferred Stock $ 0.5 07/21/2017 A 150,000 04/15/2016 ( 4 ) Common Stock 1,500,000 ( 2 ) 150,000 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
KATZAROFF JAMES C
C/O VIVOS INC
719 JADWIN AVENUE
RICHLAND, WA99352
X
Signatures
/s/ James C. Katzaroff 02/16/2018
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Shares issued to Reporting Person's spouse as payment of $66,092.56 owed for services rendered to the Issuer prior to Ms. Katzaroff's resignation.
( 2 )Shares issued to Reporting Person as payment of $206,071.51 owed for services rendered to the Issuer prior to the Reporting Person's resignation.
( 3 )See Exhibit 99.1 for additional transactions.
( 4 )The Series A Convertible Preferred Stock has no expiration date.

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