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).
  
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*
PAYNE JOHN BERNARD

(Last) (First) (Middle)
9900 NE 114TH CIRCLE

(Street)
VANCOUVER WA 98662

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Zivo Bioscience, Inc. [ ZIVO ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President and CEO
3. Date of Earliest Transaction (Month/Day/Year)
06/05/2024
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
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
Nonstatutory Stock Option to Purchase Common Stock $26.88(1) 06/05/2024 D 1,902(1) (2) 10/11/2031 Common Stock 1,902 (3) 0 D
Nonstatutory Stock Option to Purchase Common Stock $33(1) 06/05/2024 D 32,000(1) (2) 10/20/2031 Common Stock 32,000 (3) 0 D
Nonstatutory Stock Option to Purchase Common Stock $17.16(1) 06/05/2024 D 31,836(1) (2) 12/15/2032 Common Stock 31,836 (3) 0 D
Nonstatutory Stock Option to Purchase Common Stock $7.96 06/05/2024 A 167,180 (4) 06/04/2034 Common Stock 167,180 (3) 167,180 D
Nonstatutory Stock Option to Purchase Common Stock $7.96 06/05/2024 A 50,251 (4) 06/04/2034 Common Stock 50,251 $0 50,251 D
Explanation of Responses:
1. The share amount and exercise price have been adjusted from the amount reported on a previous Form 4 to reflect a 1 for 6 reverse stock split of the Issuer's stock in October 2023.
2. The canceled options were fully vested.
3. The Issuer canceled options for an aggregate 65,738 shares of the Issuer's common stock granted to the Reporting Person on 10/12/2021, 10/21/2021, and 12/16/2022. In exchange for the canceled options, the Reporting Person received a replacement option, for 167,180 shares, having an exercise price of $7.96.
4. The option was issued pursuant to the 2021 Equity Incentive Plan and all options vested immediately upon the date of acceptance of grant.
/s/ John B. Payne 06/06/2024
** 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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