SEC Form 4 · accession 0001437749-16-023581
CervoMed Inc. · CRVO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David G Kalergis
Officer — Chairman and CEO · Director
Period of report
Jan 8, 2016
Accepted (ET)
Jan 13, 2016 · 2:35 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001053691
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Jan 8, 2016 | A | 1,069,216 | — | A | 1,069,216 | D | |
| Common StockF3,F4 | Jan 8, 2016 | A | 215,506 | — | A | 215,506 | I | By Daughter |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F5 | $0.22 | Jan 8, 2016 | A | 295,865 | A | May 17, 2012 | May 17, 2022 | Common Stock | 295,865 | 295,865 | D |
| Stock Option (Right to Buy)F6,F7 | $0.22 | Jan 8, 2016 | A | 91,316 | A | — | Oct 9, 2022 | Common Stock | 91,316 | 91,316 | D |
| Stock Option (Right to Buy)F6,F7 | $0.22 | Jan 8, 2016 | A | 273,949 | A | — | Oct 9, 2022 | Common Stock | 273,949 | 273,949 | D |
| Stock Option (Right to Buy)F8,F7 | $0.35 | Jan 8, 2016 | A | 127,843 | A | — | Oct 5, 2023 | Common Stock | 127,843 | 127,843 | D |
| Stock Option (Right to Buy)F8,F7 | $0.62 | Jan 8, 2016 | A | 182,632 | A | — | Oct 5, 2023 | Common Stock | 182,632 | 182,632 | D |
| Stock Option (Right to Buy)F9,F7 | $0.42 | Jan 8, 2016 | A | 182,632 | A | — | Dec 1, 2024 | Common Stock | 182,632 | 182,632 | D |
| Stock Option (Right to Buy)F9,F7 | $0.42 | Jan 8, 2016 | A | 127,843 | A | — | Dec 1, 2024 | Common Stock | 127,843 | 127,843 | D |
| Stock Option (Right to Buy)F10,F7 | $0.55 | Jan 8, 2016 | A | 365,265 | A | — | Oct 30, 2025 | Common Stock | 365,265 | 365,265 | D |
| Stock Option (Right to Buy)F10,F4 | $0.55 | Jan 8, 2016 | A | 331,595 | A | — | Oct 30, 2025 | Common Stock | 331,595 | 331,595 | D |
Explanation of responses
- F1Received in exchange for 292,723 units of Diffusion Pharmaceuticals LLC ("Diffusion") in connection with the consummation of the merger (the "Merger") of Diffusion and a wholly-owned subsidiary of the Issuer ("Merger Sub") on January 8, 2016 based upon the exchange rate set forth in the Agreement and Plan of Merger (the "Merger Agreement"), dated December 15, 2015, by and among the Issuer, Diffusion and Merger Sub.
- F10In connection with the consummation of the Merger, an option originally granted on October 30, 2015 to purchase membership units in Diffusion was converted into an option to purchase common stock of the Issuer.
- F2382,517 shares held jointly with Mr. Kalergis' spouse.
- F3Received in exchange for 59,000 units of Diffusion in connection with the consummation of the Merger on January 8, 2016 based upon the exchange rate set forth in the Merger Agreement.
- F4Securities held by Mr. Kalergis' daughter. Mr. Kalergis disclaims beneficial ownership of such securities.
- F5In connection with the consummation of the Merger, an option originally granted on May 17, 2012 to purchase membership units in Diffusion was converted into an option to purchase common stock of the Issuer.
- F6Pursuant to the Merger, an option originally granted on October 9, 2012 to purchase membership units in Diffusion was converted into an option to purchase common stock of the Issuer.
- F7The shares underlying the options vest in equal parts each month until fully vested on the third anniversary of the grant date.
- F8In connection with the consummation of the Merger, an option originally granted on October 5, 2013 to purchase membership units in Diffusion was converted into an option to purchase common stock of the Issuer.
- F9In connection with the consummation of the Merger, an option originally granted on December 1, 2014 to purchase membership units in Diffusion was converted into an option to purchase common stock of the Issuer.