SEC Form 4 · accession 0001567619-18-007142
BLONDER TONGUE LABORATORIES INC · BDR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jeffrey W Smith
Officer — Vice President - Sales
Period of report
Nov 28, 2018
Accepted (ET)
Nov 30, 2018 · 1:43 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001000683
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, par value $0.001F1 | Nov 28, 2018 | M | 12,500 | $0.55 | A | 52,500 | D | |
| Common Stock, par value $0.001F1 | Nov 28, 2018 | F | 5,851 | $0.55 | D | 46,649 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (right to buy)F1,F2 | $0.55 | Nov 28, 2018 | M | 12,500 | A | — | Apr 14, 2027 | Common Stock par value $0.001 | 12,500 | 25,000 | D |
Explanation of responses
- F1Represents a "net exercise" of the identified stock option. The reporting person received 6,649 shares of common stock on net exercise of an option to purchase 12,500 shares of common stock, with 5,851 shares of common stock underlying the option withheld in satisfaction of the exercise price of the option.
- F2The stock option covers 37,500 shares of common stock and vests in three equal installments of one-third each on the first, second and third anniversary of April 4, 2017, the date of grant.