SEC Form 4 · accession 0001437749-19-000205
Sun BioPharma, Inc. · SNBP
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael T. Cullen
Officer — Exec. Chairman, Pres. & CEO · Director · 10% Owner
Period of report
Dec 31, 2018
Accepted (ET)
Jan 3, 2019 · 4:54 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001029125
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible Promissory NoteF2,F1 | $3.50 | Dec 31, 2018 | P | 35,000 | A | Dec 31, 2018 | Jun 30, 2019 | Common Stock | 10,000 | 0 | D |
| Warrant (right to buy)F2 | $4.50 | Dec 31, 2018 | P | 20,000 | A | Dec 31, 2018 | Dec 31, 2023 | Common Stock | 20,000 | 20,000 | D |
Explanation of responses
- F1All amounts due under the note will automatically convert into shares of common stock of the Issuer based on an initial conversion price of $3.50 per share upon maturity (subject to certain adjustments).
- F2The reporting person purchased the convertible promissory note and warrants, in a single transaction, for an aggregate amount of $35,000.