Sec Form 4 Filing - Rudelius Robert James @ PetVivo Holdings, Inc. - 2018-01-03

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 *
Rudelius Robert James
2. Issuer Name and Ticker or Trading Symbol
PetVivo Holdings, Inc. [ PETV]
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)
5251 EDINA INDUSTRIAL BLVD
3. Date of Earliest Transaction (MM/DD/YY)
01/03/2018
(Street)
EDINA, MN55439
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 12/31/2018 J 66,667 ( 1 ) A $ 0.3 565,282 I By Noble Ventures LLC
Common Stock 12/31/2018 X 10,000 ( 2 ) A $ 0.3 575,282 I By Noble Ventures LLC
Common Stock 12/31/2018 J 3,333 ( 3 ) A $ 0.3 578,615 I By Noble Ventures LLC
Common Stock 12/31/2018 X 10,000 ( 4 ) A $ 0.3 588,615 I By Noble Ventures LLC
Common Stock 12/31/2018 J 3,333 ( 5 ) A $ 0.3 591,948 I By Noble Ventures LLC
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
Common Stock Warrant $ 0.3 12/31/2018 A 10,000 12/31/2018 12/31/2021 Common Stock 10,000 ( 2 ) $ 20,000 97,500 I By Noble Ventures LLC
Common Stock Warrant $ 0.3 12/31/2018 X 10,000 12/31/2018 12/31/2021 Common Stock 10,000 ( 2 ) $ 20,000 87,500 I By Noble Ventures LLC
Common Stock Warrant $ 0.3 12/31/2018 A 10,000 12/31/2018 12/31/2018 Common Stock 10,000 ( 4 ) $ 20,000 97,500 I By Noble Ventures LLC
Common Stock Warrant $ 0.3 12/31/2018 X 10,000 12/31/2018 12/31/2018 Common Stock 10,000 ( 4 ) $ 20,000 87,500 I By Noble Ventures LLC
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Rudelius Robert James
5251 EDINA INDUSTRIAL BLVD
EDINA, MN55439
X
Signatures
/s/ Robert Rudelius 01/03/2019
** Signature of Reporting Person Date
Explanation of Responses:
( 1 )Mr. Rudelius entered into a Bridge Promissory Note Agreement and subsequently a Bridge Promissory Note Conversion Agreement whereby he converted his $20,000 in outstanding principal and interest into 66,667 shares of Common Stock at a rate of $.30 per share.
( 2 )Pursuant to entering into a Bridge Promissory Note Agreement, Mr. Rudelius received 10,000 warrants exercisable at $.30 per warrant if exercised on or before December 31, 2018.
( 3 )Pursuant to exercising the warrants mentioned in explanation 2 above, Mr. Rudelius and John Lai entered into a Stock Transfer Agreement whereby John Lai Transferred 3,333 shares of Common Stock to Mr. Rudelius.
( 4 )Pursuant to entering into a Bridge Promissory Note Conversion Agreement, Mr. Rudelius received 10,000 warrants exercisable at $.30 per warrant if exercised on or before December 31, 2018.
( 5 )Pursuant to exercising the warrants mentioned in explanation 4 above, Mr. Rudelius and John Lai entered into a Stock Transfer Agreement whereby John Lai Transferred 3,333 shares of Common Stock to Mr. Rudelius.

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