Sec Form 3/A Filing - Kruse William R @ PreCheck Health Services, Inc. - 2019-12-24-07:00

Insider filing report for Changes in Beneficial Ownership
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FORM 3/A
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
Kruse William R
2. Issuer Name and Ticker or Trading Symbol
PreCheck Health Services, Inc. [ HLTY]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
1340 S. MAIN ST., SUITE 300
3. Date of Earliest Transaction (MM/DD/YY)
12/24-07:00/2019
(Street)
GRAPEVINE, TX76051
4. If Amendment, Date Original Filed (MM/DD/YY)
01/07-07:00/2020
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, par value $0.0001 per share 1,500,368 D
Common stock, par value $0.0001 per share 232,820 I Jointly with spouse
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
(1) ( 1 ) ( 1 ) ( 1 ) ( 1 ) (1) ( 1 ) ( 1 ) D
common stock purchase warrant ( 1 ) 04/02-06:00/2019 04/02-06:00/2022 Common stock 125,000 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Kruse William R
1340 S. MAIN ST.
SUITE 300
GRAPEVINE, TX76051
X
Signatures
/s/ William R. Kruse 02/03-07:00/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )On March 20, 2018, the Company issued to Mr. Kruse for $75,000 a convertible note for $80,250 and warrants to purchase 75,000 shares of common stock at $1.20 per share, subject to adjustment. On September 30, 2018, the Company entered into a note amendment with the note settlement amount amended to $90,000 and note expiry date extended to March 30, 2019. The Company and Mr. Kruse entered into extension agreements, most recently on January 6, 2020 extending to June 20, 2020, the date on which the note is to be paid. Pursuant to the extension agreement, Mr. Kruse agreed not to convert the note or exercise the warrant prior to June 30, 2020, to sell the Note to the Company for $90,000 and to either accept $12,500 or 37,500 shares in exchange for the warrant.

Remarks:
This amendment corrects the number of shares owned by Mr. Kruse.

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