SEC Form 4 · accession 0001437749-17-000112
OMNICOMM SYSTEMS INC · OMCM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas E Vickers
Officer — Chief Financial Officer
Period of report
Dec 30, 2016
Accepted (ET)
Jan 4, 2017 · 1:36 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001034592
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Dec 30, 2016 | M | 100,000 | $0.045 | A | 400,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionF2 | $0.045 | Dec 30, 2016 | M | 100,000 | D | Dec 30, 2012 | Dec 30, 2016 | Common Stock | 100,000 | 0 | D |
Explanation of responses
- F1On December 30, 2011, the Issuer awarded 100,000 employee stock options to the Reporting Person in accordance with Rule 16b-3, which options vested in two annual installments on the first and second anniversary of the grant date. The transactions reported on this Form 4 represent the exercise and conversion of the 100,000 employee stock options exempted pursuant to Rule 16b-3.
- F250,000 exercisable 12/30/2012 and 50,000 exercisable 12/30/2013