SEC Form 4 · accession 0001569608-16-000064
Modsys International Ltd · MDSYF
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Columbia Pacific Advisors, LLC
10% Owner
Period of report
Sep 30, 2016
Accepted (ET)
Oct 6, 2016 · 9:50 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 |
|---|---|---|---|---|---|---|---|---|
| Ordinary SharesF1 | Sep 30, 2016 | P | 100 | $1.25 | A | 5,344,099 | I | General Partner |
| Ordinary SharesF1,F2 | Oct 6, 2016 | P | 100 | $1.00 | A | 5,344,199 | I | General Partner |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Acquired by Columbia Pacific Opportunity Fund, L.P.
- F2Columbia Pacific Opportunity Fund, L.P. owns 5,306,259 Ordinary Shares Columbia Pacific Partners Fund (Delaware), L.P. owns 37,940 Ordinary Shares