Tom Kubota - 03 Jun 2026 Form 4 Insider Report for PACIFIC HEALTH CARE ORGANIZATION INC (PFHO)

Reporting relationship: CEO & President, Director, 10%+ Owner
Issuer ticker: PFHO
Reported as of: 03 Jun 2026
Net transaction value: +$24,742
SEC form: 4
Accepted by SEC: 04 Jun 2026, 12:56:22 UTC
Prior SEC filing: 02 Jun 2026
Source filing: View source filing
Reporting owner signature: /s/ Tom Kubota

Key filing fact

Tom Kubota filed Form 4 for PACIFIC HEALTH CARE ORGANIZATION INC (PFHO) on 04 Jun 2026.

Key facts

This page summarizes Tom Kubota's Form 4 filing for PACIFIC HEALTH CARE ORGANIZATION INC (PFHO).
1 reported transaction and 1 derivative row are listed below.
Accepted by SEC: 04 Jun 2026, 12:56.

Change

Previous filing in this sequence was filed on 02 Jun 2026.
Current net transaction value: +$24,742.

Research use

This tells you what this filing adds before you inspect full transaction and derivative tables.
You can trace every row back to the original SEC filing document.

Evidence

Filed on Form 4

Ownership activity is grounded in SEC Form 4 disclosures.

View source filing

Reporting Owners (1)

CIK 0001271519 Primary reporting owner

KUBOTA TOM

Relationship: CEO & President, Director, 10%+ Owner
Address: 2618 SAN MIGUEL DRIVE, #477, NEWPORT BEACH
Signature: /s/ Tom Kubota
Signature date: 04 Jun 2026

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

PFHO transaction

Common

Purchase

Transaction value: $24,742
Shares: +24,742
Change %: +0.29%
Price: $1.00
Shares after: 8,500,000
Date: 03 Jun 2026
Ownership: Direct
Footnotes: F1

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

PFHO holding Derivative

Series A Preferred

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after: 16,000
Date: 03 Jun 2026
Ownership: Direct
Underlying class: Common Stock
Underlying amount: 16,000
Exercise price: $0.000000
Footnotes: F1, F2

^* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 2 footnotes

Footnote F1

The Reporting Person holds the shares through the Tom Kubota Revocable Trust of 2013 (the "Trust"). The Reporting Person is the sole Trustee of the Trust. As such, the Reporting Person may be deemed to have voting and/or investment power over the shares held by the Trust and therefore may be deemed to be the beneficial owner of those shares.

Footnote F2

The Series A Preferred Stock converts into Common Stock of the Issuer on a 1:1 basis at any time at the election of the Reporting Person and has no expiration date.