Statement of Changes in Beneficial Ownership (4)
Date :
Statement of Changes in Beneficial Ownership (4)
Date : 09/12/2014 @ 7:25PM
Source : Edgar (US Regulatory)
Stock : N^NXTD (NXTD)
Quote : 2.31 0.0 (0.00%) @ 2:05AM
Statement of Changes in Beneficial Ownership (4)
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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 OF SECURITIES
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OMB Number: 3235-0287
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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
1. Name and Address of Reporting Person *
Pereira Gino Miguel 2. Issuer Name and Ticker or Trading Symbol
Nxt-ID, Inc. [ NXTD ] 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
__ X __ Director __ X __ 10% Owner
__ X __ Officer (give title below) _____ Other (specify below)
Chief Executive Officer
(Last) (First) (Middle)
4 RESEARCH DRIVE #402 3. Date of Earliest Transaction (MM/DD/YYYY)
9/10/2014
(Street)
SHELTON, CT 06484
(City) (State) (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_ X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3) 2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr.
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 9/10/2014 D 60000 D $0.00 (1) 10608922 D
Common Stock 9/10/2014 D 600000 D $0.00 (2) 10008922 D
Common Stock 9/10/2014 D 40000 D $0.00 (3) 9968922 D
Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Trans. Date 3A. Deemed Execution Date, if any 4. Trans. Code
(Instr.
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date 7. Title and Amount of Securities Underlying Derivative Security
(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
Explanation of Responses:
( 1) Pursuant to a Purchase Agreement in a private offering by the Issuer of shares and warrants (the "Offering"
, the Issuer's founders who are members of management (the "Founders"
agreed to cancel a corresponding number of shares to those shares issued in the Offering and place in escrow a corresponding number of shares to be cancelled for each warrant share issued.
( 2) The shares of common stock were transferred by Mr. Pereira to certain transferees as a gift.
( 3) The shares of common stock were transferred to a certain transferee for services rendered.
Reporting Owners
Reporting Owner Name / Address
Relationships
Director 10% Owner Officer Other
Pereira Gino Miguel
4 RESEARCH DRIVE #402
SHELTON, CT 06484 X X Chief Executive Officer
Signatures
/s/ Gino Miguel Pereira 9/12/2014
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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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