SEC Form 3 · accession 0001213900-16-012686
Modsys International Ltd · MDSYF
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Richard T. Chance
Officer — CFO
Period of report
Apr 16, 2016
Accepted (ET)
Apr 21, 2016 · 2:45 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001029581
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| MDSY Common Stock | holding | — | — | — | 57,172 | D | ||
| Ordinary SharesF1 | holding | — | — | — | 5,208,167 | I | By Mindus Holdings, LTD |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF2 | $0.00 | holding | — | — | — | — | Apr 16, 2026 | Common Stock | 50,000 | — | D |
Explanation of responses
- F1Pursuant to a Bonus Agreement between the Reporting Person and Mindus Holdings Ltd. ("Mindus"), the Reporting Person is entitled to receive 1.1% of the proceeds relating to any sale or transfer of, or any dividend or distribution on, such shares held by Mindus, less certain expenses, provided such sale, transfer, dividend or distribution occurs on or before December 1, 2024. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
- F230,000 RSUs eligible to vest on April 16, 2017. 2,500 RSUs eligible to vest monthly afterward until December 16, 2017. Vesting does not happen until later of separation of employment or 12 months of service.