Johnson Scott Mitchell Form 3 PetVivo / Scott Mitchell Johnson ownership change

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

Johnson Scott Mitchell

(Last) (First) (Middle)

5251 EDINA INDUSTRIAL BLVD

(Street)

EDINA MN 55439

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
06/20/2019

3. Issuer Name and Ticker or Trading Symbol
PetVivo Holdings, Inc. [ PETV ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

5. If Amendment, Date of Original Filed (Month/Day/Year)

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 Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	593,503(2)	D

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Common Stock Warrant	06/03/2019	06/03/2024	Common Stock	100,000(1)	0.3	D

Explanation of Responses:

1. In consideration of becoming a Director of PetVivo Holdings, Inc. for an initial term of two years, Scott Johnson received a warrant for purchase of 100,000 shares of common stock, 50,000 vest immediately and 50,000 vest quarterly during the second year, with an exercise price of $.30 per share for a term of 5 years.

2. These 593,503 shares of common stock represent acquisitions that occurred prior to Scott Johnson becoming a director of PetVivo Holdings, Inc.

	/s/ Scott Mitchell Johnson	08/20/2019
	** 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 5 (b)(v).
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