Please wait
SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
1. Name and Address of Reporting Person*
GUETTLER GREG H

(Last) (First) (Middle)
2915 WATERS ROAD, SUITE 108

(Street)
EAGAN MN 55121

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
HYPERTENSION DIAGNOSTICS INC /MN [ HDII ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President
3. Date of Earliest Transaction (Month/Day/Year)
12/18/2003
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 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 25,000 D
Common Stock 02/09/2004 P 20,356 A (4) 20,356 D
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 (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 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 (Month/Day/Year) 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: 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
Options (right to buy) (1) (1) (1) Common Stock 150,000 144,000 D
Options (right to buy) (1) (1) (1) Common Stock 5,000 5,000 D
Options (right to buy) (1) (1) (1) Common Stock 25,428 25,428 D
Class B Warrants (right to buy) (1) (1) (1) Common Stock 4,000 4,000 D
Options (right to buy) (1) (1) (1) Common Stock 30,000 30,000 D
Options (right to buy) (1) (1) (1) Common Stock 25,000 25,000 D
Options (right to buy) (1) (1) (1) Common Stock 150,000 150,000 D
Options (right to buy) $0.2 12/18/2003 A 400,000 (2) 12/18/2013 Common Stock 400,000 (3) 400,000 D
Series A Preferred Stock (4) 02/09/2004 P 1,280 (5) (6) Common Stock 1,280 (3) 1,280 D
Common Stock Warrant (right to buy) $0.17(4) 02/09/2004 P 20,356 (5) 05/09/2004 Common Stock 20,356 (3) 20,356 D
Common Stock Warrant (right to buy) $0.22(4) 02/09/2004 P 16,285 (5) 08/09/2004 Common Stock 16,285 (3) 16,285 D
Common Stock Warrant (right to buy) $0.3(4) 02/09/2004 P 14,250 (5) 11/09/2004 Common Stock 14,250 (3) 14,250 D
Series A Preferred Stock Warrant (right to buy) $2.04(4) 02/09/2004 P 1,280 (5) 05/09/2004 Series A Preferred Stock 1,280 (3) 1,280 D
Series A Preferred Stock Warrant (right to buy) $2.64(4) 02/09/2004 P 1,024 (5) 08/09/2004 Series A Preferred Stock 1,024 (3) 1,024 D
Series A Preferred Stock Warrant (right to buy) $3.6(4) 02/09/2004 P 896 (5) 11/09/2004 Series A Preferred Stock 896 (3) 896 D
Explanation of Responses:
1. Previously reported.
2. Grant vest as follows: 33.33% on 12/18/2004, 33.33% on 12/18/2005 and 33.33% on 12/18/2006.
3. See Table II, Column Item No. 2.
4. The reported securities are included w/in 1,280 Units purchased by reporting person for $3.9064/Unit. Ea. Unit consists of 1 share of Co.'s Series A Convertible Pref. Stock, 15.903 shares of common & 6 warrants:(a)1 9-mo. pref. stock ("PS") purchase warrant permits holder ("H") to buy 1 share of Series A Pref. at exercise price of $2.04/share;(b)1 9-mo. common stock ("CS") purchase warrant permits H to buy up to the # of shares of CS initially included in the Unit at exercise price $0.17/share;(c) 1 18-mo. PS purchase warrant permitting H to buy 80% of 1 share of Series A Pref. at exercise price $2.64/share;(d)1 18-mo. CS purchase warrant permits H to buy up to 80% of the # of shares of CS initially included in the Unit at exercise price $0.22/share; (e)1 60-mo. PS purchase warrant permits H to buy 70% of 1 share of the Series A Pref. at exercise price $3.60/share & (f) 1 60-mo. CS purchase warrant permits H to buy up to 70% of the # of CS initially incl. in the Unit at $0.30/share.
5. Immediately.
6. Not applicable.
/s/ Julie Stewart, by power of attorney 03/09/2004
** 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 Number.