SEC Form 4 · accession 0001720515-17-000004
SIERRA MONITOR CORP /CA/ · SRMC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jeffrey Stuart Brown
Officer — Chief Executive Officer
Period of report
Oct 16, 2017
Accepted (ET)
Oct 24, 2017 · 5:00 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000100625
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Restricted Common StockF1 | Oct 16, 2017 | A | 150,000 | $1.20 | A | 150,000 | 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 OptionF3,F2 | $1.20 | Oct 16, 2017 | A | 350,000 | A | Oct 16, 2018 | Oct 16, 2027 | Common Stock | 350,000 | 350,000 | D |
Explanation of responses
- F125% of the shares subject to vest on 10/16/2018 with the remaining shares vesting at 25% on each annual anniversary thereafter.
- F225% of the shares subject to vest on 10/16/2018 with the remaining shares vesting at 1/36th per month.
- F3Granted by the issuer under the 2016 Stock Option Plan