Insider filing report for Changes in Beneficial Ownership
- Schedule 13G & 13D forms are used to report a party's ownership of stock which exceeds 5% of a company's total stock issue.
- Schedule 13G is a shorter version of Schedule 13D with fewer reporting requirements.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
SCHEDULE 13D
Under the Securities Exchange Act of 1934
INTEGRITY APPLICATIONS, INC.
Name of Issuer
Common Stock, $0.001Par Value Per Share
Title of Class of Securities
45824Q101
CUSIP Number
John Ballantyne, Trustee
7410 Claire Drive South
Fargo, ND 58104
(701) 306-6118
Name, Address and Telephone Number of Person
Authorized to Receive Notices and Communications
February 14, 2020
Date of Event which Requires Filing of this Statement
If the filing person has previously filed a statement on Schedule 13G to report the acquisition which is the subject of this Schedule 13D, and is filing this schedule because of Rule 13d-1(e), 13d-1(f) or 13d-1(g), check the following box. [ ]
Note: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See Rule 13d-7 for other parties to whom copies are to be sent.
The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for and subsequent amendment containing information which would alter disclosures provided in a prior cover page.
The information required on the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
| CUSIP No. 45824Q101 |
| 1. | Name of Reporting Person | Tax Identification Number |
| JOHN A BALLANTYNE REV TRUST 08/01/2017 | ||
| 2. | Check the Appropriate Box if a Member of a Group | (a) [ ] |
| (b) [ ] | ||
| 3. | SEC Use Only | |
| 4. | Source of Funds | |
| WC | ||
| 5. | Check if Disclosure of Legal Proceedings is Required pursuant to Items 2(d) or 2(e) [ ] | |
| 6. | Citizenship or Place of Organization | |
| Mr. Ballantyne, the trustee of the Reporting Person, is a New Zealand Citizen, and a permanent resident of the United States. | ||
| Number of | 7. Sole Voting Power | |
| Shares | ||
| Beneficially | ||
| Owned by | 8. Shared Voting Power | |
| Each | ||
| Reporting | 66,284,003 (beneficially owned by Trust, of which Ballantyne is sole trustee.) | |
| Person | ||
| With | 9. Sole Dispositive Power | |
| 10. Shared Dispositive Power | ||
| 66,284,003 (beneficially owned by Trust, of which Ballantyne is sole trustee.) | ||
| 11. | Aggregate Amount Beneficially Owned by Each Reporting Person | |
| 66,284,003 (does not include 4,923,336 warrants which are not currently exerciseable) | ||
| 12. | Check if the Aggregate Amount in Row 11 Excludes Certain Shares [ ] | |
| 13. | Percent of Class Represented by Amount in Row 11 | |
| Common Stock: 33.25% | ||
| 14. | Type of Reporting Person | |
| OO | ||
| 2 |
CUSIP No. 45824Q101
| 1. | Name of Reporting Person | Tax Identification Number |
| JOHN A BALLANTYNE | ||
| 2. | Check the Appropriate Box if a Member of a Group | (a) [ ] |
| (b) [ ] | ||
| 3. | SEC Use Only | |
| 4. | Source of Funds | |
| PF | ||
| 5. | Check if Disclosure of Legal Proceedings is Required pursuant to Items 2(d) or 2(e) [ ] | |
| 6. | Citizenship or Place of Organization | |
| Mr. Ballantyne is a New Zealand Citizen, and a permanent resident of the United States. | ||
| Number of | 7. Sole Voting Power | < /font> |
| Shares | ||
| Beneficially | 17,408 | |
| Owned by | ||
| Each | 8. Shared Voting Power | |
| Reporting | ||
| Person | 66,284,003 (beneficially owned by Trust, of which Ballantyne is sole trustee.) | |
| With | ||
| 9. Sole Dispositive Power | ||
| 17,408 | ||
| 10. Shared Dispositive Power | ||
| 66,284,003 (beneficially owned by Trust, of which Ballantyne is sole trustee.) | ||
| 11. | Aggregate Amount Beneficially Owned by Each Reporting Person | |
| 66,301,411 | ||
| 12. | Check if the Aggregate Amount in Row 11 Excludes Certain Shares [ ] | |
| 13. | Percent of Class Represented by Amount in Row 11 | |
| Common Stock: 33.26% | ||
| 14. | Type of Reporting Person | |
| IN | ||
| 3 |
SCHEDULE 13D
OF JOHN BALLANTYNE AND JOHN A BALLANTYNE REV TRUST 08/01/2017
REGARDING OWNERSHIP OF SECURITIES OF INTEGRITY APPLICATIONS, INC.
This Schedule 13D is being filed by John A. Ballantyne and JOHN A BALLANTYNE REV TRUST 08/01/2017 (the “Trust”), and John A. Ballantyne, the Trustee of the Trust, (“Ballantyne”).
The following items of this Schedule 13D are amended:
Item 1. Security and Issuer.
This Schedule 13D relates to the Common Stock, par value $0.001 per share, of Integrity Applications, Inc., with an address of 19 HA’YAHALOMIM STP.O. BOX 12163ASHDOD L3 7760049.
Item 2. Identity and Background.
| a. | Name: John A. Ballantyne Rev Trust 08/01/2017 and John A. Ballantyne | |
| b. | Address: 7410 Claire Drive South, Fargo, ND 58104 (for both) | |
| c. | Principal Occupation: Ballantyne is a scientist and is employed by Aldevron, Inc., 4055 41st Avenue South, Fargo, North Dakota 58104, USA, phone (701) 297-9256. | |
| d. | Criminal Proceeding: During the last five years, neither the Trust nor Ballantyne has been convicted in a criminal proceeding. | |
| e. | Civil Proceeding: During the last five years, neither the Trust nor Ballantyne was a party to a civil proceeding of a judicial or administrative body of competent jurisdiction and as a result of such proceeding was or is subject to a judgment, decree or final order enjoining future violations of, or prohibiting or mandating activities subject to, federal or state securities laws or finding any violation with respect to such laws. | |
| f. | Ballantyne is a New Zealand citizen. |
Item 3. Source and Amount of Funds or Other Consideration.
The Trust used cash which was deposited into the Trust by Ballantyne.
Item 4. Purposes of Transactions.
On February 14, 2020, the Trust purchased 37,500,000 shares of common stock of the issuer at a price of $0.40 per share as a passive investment.
Item 5. Interest in the Securities of the Issuer.
As a result of the acquisition of shares set forth in Item 4. above, the Trust owns 66,284,003 shares of common stock of the issuer, which constitutes 33.25% of the issued and outstanding shares of the issuer. Ballantyne, as the sole trustee of the Trust, which is revocable, is deemed to beneficially own all shares of stock of the issuer owned by the Trust and thus beneficially owns 66,301,411 shares of common stock of the issuer or 33.26%.
Item 6. Contracts, Arrangements, Understandings or Relationships With Respect to Securities of the Issuer.
None.
Item 7. Exhibits.
None.
| 4 |
SIGNATURES
After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
| Dated: | February 25, 2020 | JOHN A BALLANTYNE REV TRUST 08/01/2017 | ||
| By: | /s/ John A. Ballantyne | |||
| John A. Ballantyne | ||||
| Trustee | ||||
| Dated: | February 25, 2020 | By: | /s/ John A. Ballantyne | |
| John A. Ballantyne | ||||
| 5 |