Filing Details

Accession Number:
0001144204-11-028782
Form Type:
4
Zero Holdings:
No
Publication Time:
2011-05-13 09:54:22
Reporting Period:
2011-05-11
Filing Date:
2011-05-13
Accepted Time:
2011-05-13 09:54:22
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1000278 Pacifichealth Laboratories Inc PHLI Medicinal Chemicals & Botanical Products (2833) 223367588
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1053278 Robert Portman C/O Pacifichealth Laboratories, Inc.
100 Matawan Road, Suite 420
Matawan NJ US 07747
Yes No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2011-05-11 400,000 $0.25 2,936,854 No 4 P Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Warrant Acquisiton 2011-05-11 200,000 $0.00 200,000 $0.31
Common Stock Warrant Acquisiton 2011-05-11 40,000 $0.00 40,000 $0.38
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
200,000 2011-05-11 2014-05-11 No 4 P Direct
40,000 2011-05-11 2014-05-11 No 4 P Direct