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
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Sakiris Spiro Kevin

(Last) (First) (Middle)
C/O INTELLIGENT BIO SOLUTIONS INC.,
142 WEST 57TH STREET, 11TH FLOOR

(Street)
NEW YORK NY 10019

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
INTELLIGENT BIO SOLUTIONS INC. [ INBS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
3. Date of Earliest Transaction (Month/Day/Year)
05/10/2023
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
Rule 10b5-1(c) Transaction Indication

  
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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 3,765(1) D
Common Stock 05/10/2023(2) C 2,399 A $5.8 4,745(1)(3) I Held by Anest Holdings(4)
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
Series D Convertible Preferred Stock(1)(2)(3) (2) 05/10/2023(2) C 15,993(1) (2) (2) Common Stock 2,399(1) $0 0 I Held by Anest Holdings(4)
Explanation of Responses:
1. On February 9, 2023, the Issuer effected a 1-for-20 reverse stock split of its common stock (the "Reverse Split"). Unless otherwise noted, the amount of securities and purchase prices reported on this Form 4 have been adjusted to reflect the Reverse Split. This Form 4 also corrects the number of securities held directly and indirectly by Mr. Sakiris. Prior to the Reverse Split, each share of Series D Convertible Preferred Stock (the "Preferred Stock") was convertible into 3 shares of common stock. Following the Reverse Split, each share of Preferred Stock was convertible into 0.15 shares of common stock.
2. Following the Trigger Date (defined below), each share of Preferred Stock was convertible at any time at the option of the holder and without payment of further consideration. The Preferred Stock has no expiration date. The term "Trigger Date" means the earlier to occur of (i) the date that the last of (a) the shareholders approve conversion of the Preferred Stock or (b) the shareholders approve a reverse split of the Issuer's common stock; or (ii) the date which is 60 days following the date on which the common stock is no longer listed on the Nasdaq, the NYSE or the NYSE American. The Issuer's stockholders approved the conversion of the Preferred Stock at a meeting of stockholders on May 8, 2023, and effective as of May 10, 2023, all shares Preferred Stock were converted into common stock.
3. On December 22, 2022, Anest Holdings Pty Ltd, as trustee of ATF S&T Sakiris Superannuation Fund, purchased 15,993 units from the Issuer in a private placement. Each unit consists of one share of Series D Convertible Preferred Stock (valued at $0.87 each (pre- Reverse Split)) and three common stock purchase warrants (collectively valued at $0.35(pre- Reverse Split), or $0.1267 each (pre- Reverse Split)). The purchase price of each unit was $1.25 per unit (pre- Reverse Split).
4. These securities are held by Anest Holdings Pty Ltd, as trustee of ATF S&T Sakiris Superannuation Fund, of which Mr. Sakiris is a director.
/s/ Spiro Sakiris 07/11/2023
** 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).
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