o | Rule 13d-1(b) |
o | Rule 13d-1(c) |
x | Rule 13d-1(d) |
CUSIP
No. 03875V-10-7 | ||||
1. |
Names
of Reporting Persons.
I.R.S.
Identification Nos. of above persons (entities only).
Jacek
Rozga
| |||
|
2.
|
Check
the Appropriate Box if a Member of a Group (See
Instructions) | ||
(a) |
||||
(b) |
| |||
3. |
SEC
Use Only
| |||
|
4. |
Citizenship
or Place of Organization
USA | ||
Number
of
Shares
Beneficially
Owned
by
Each
Reporting
Person
With |
||||
5. Sole
Voting
Power
2,331,000 | ||||
6. Shared
Voting Power. | ||||
7. Sole
Dispositive
Power
2,331,000 | ||||
| ||||
8. Shared
Dispositive Power | ||||
9. |
Aggregate
Amount Beneficially Owned by Each Reporting
Person
2,331,000 | |||
|
10. |
Check
if the Aggregate Amount in Row (9) Excludes Certain Shares (See
Instructions) | ||
|
11. |
Percent
of Class Represented by Amount in Row (9) 14.3% | ||
|
12. |
Type
of Reporting Person (See Instructions) | ||
IN |
| |||
Item
1. | |||
(a) |
Name
of Issuer | ||
Arbios
Systems, Inc. | |||
(b) |
Address
of Issuer's Principal Executive Offices | ||
8797
Beverly Blvd., Suite 206, Los Angeles, California,
90048 | |||
Item
2. | |||
(a) |
Name
of Person Filing | ||
Jacek
Rozga | |||
(b) |
Address
of Principal Business Office or, if none, Residence | ||
8797
Beverly Blvd., Suite 206, Los Angeles, California,
90048 | |||
(c) |
Citizenship | ||
USA | |||
(d) |
Title
of Class of Securities | ||
Common
Stock | |||
(e) |
CUSIP
Number | ||
03875V-10-7 | |||
Item
3. |
If
this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c),
check whether the person filing is a: | ||
(a) |
o |
Broker
or dealer registered under section 15 of the Act (15 U.S.C.
78o). | |
(b) |
o |
Bank
as defined in section 3(a)(6) of the Act (15 U.S.C.
78c). | |
(c) |
o |
Insurance
company as defined in section 3(a)(19) of the Act (15 U.S.C.
78c). | |
(d) |
o |
Investment
company registered under section 8 of the Investment Company Act of 1940
(15 U.S.C 80a-8). | |
(e) |
o |
An
investment adviser in accordance with
§240.13d-1(b)(1)(ii)(E); | |
(f) |
o |
An
employee benefit plan or endowment fund in accordance with
§240.13d-1(b)(1)(ii)(F); | |
(g) |
o |
A
parent holding company or control person in accordance with §
240.13d-1(b)(1)(ii)(G); | |
(h) |
o |
A
savings associations as defined in Section 3(b) of the Federal Deposit
Insurance Act (12 U.S.C. 1813); | |
(i) |
o |
A
church plan that is excluded from the definition of an investment company
under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C.
80a-3); | |
(j) |
o |
Group,
in accordance with §240.13d-1(b)(1)(ii)(J). |
| |||
Item
4. |
Ownership. | ||
Provide
the following information regarding the aggregate number and percentage of
the class of securities of the issuer identified in Item 1.
| |||
(a) |
Amount
beneficially owned: 2,331,000. | ||
(b) |
Percent
of class: 14.3%. | ||
(c) |
Number
of shares as to which the person has: | ||
(i) |
Sole
power to vote or to direct the vote | ||
2,331,000 | |||
(ii) |
Shared
power to vote or to direct the vote | ||
0 | |||
(iii) |
Sole
power to dispose or to direct the disposition of | ||
2,331,000 | |||
(iv) |
Shared
power to dispose or to direct the disposition of | ||
0 | |||
Instruction.
For computations regarding securities which represent a right to acquire
an underlying security see
§240.13d3(d)(1). | |||
Item
5. |
Ownership
of Five Percent or Less of a Class | ||
Not
Applicable |
Item
6. |
Ownership
of More than Five Percent on Behalf of Another
Person. | |
Not
Applicable | ||
Item
7. |
Identification
and Classification of the Subsidiary Which Acquired the Security Being
Reported on By the Parent Holding Company | |
Not
Applicable | ||
Item
8. |
Identification
and Classification of Members of the Group | |
Not
Applicable | ||
Item
9. |
Notice
of Dissolution of Group | |
Not
Applicable | ||
Item
10. |
Certification | |
Not
Applicable |
03/03/05________________________ | |
Date | |
/s/ Jacek Rozga ___________________ | |
Signature | |
Jacek Rozga, President and Chief Financial Officer | |
Name/Title |