SEC Form 4 · accession 0001437749-17-005424
OMNICOMM SYSTEMS INC · OMCM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Randall G Smith
Officer — Chief Technology Officer · Director
Period of report
Mar 24, 2017
Accepted (ET)
Mar 28, 2017 · 4:05 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001034592
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionF1,F2 | $0.25 | Mar 24, 2017 | A | 500,000 | A | Mar 31, 2018 | Mar 24, 2022 | Common stock | 500,000 | 500,000 | D |
Explanation of responses
- F1Issued pursuant to the terms and conditions of the 2016 Equity Incentive Plan of OmniComm Systems, Inc.
- F2250,000 exercisable on March 31, 2018 and 250,000 exercisable on March 31, 2019 subject to the achievement of financial performance goals in 2017.