SEC Form 4 · accession 0001415889-16-005660
POLARITYTE, INC. · PTE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mohit Bhansali
Director
Period of report
Dec 17, 2014
Accepted (ET)
Apr 27, 2016 · 4:51 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001076682
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, par value $0.001F1 | Dec 17, 2014 | A | 6,740 | — | A | 6,740 | D | |
| Common Stock, par value $0.001F2,F3,F4 | Apr 25, 2016 | A | 150,000 | — | A | 181,640 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OptionF5 | $0.80 | Apr 25, 2016 | A | 150,000 | A | — | Apr 25, 2026 | Common Stock | 150,000 | 150,000 | D |
Explanation of responses
- F1Represents a restricted stock award (the "2014 RSA") under the Issuer's Amended and Restated 2004 Employee, Director and Consultant Incentive Plan. The vesting of these shares was subject to a trigger event that occurred on September 30, 2015, which vested the shares in full.
- F2Represents a restricted stock award (the "2016 RSA") under the Issuer's 2016 Equity Incentive Plan. The Restricted Stock Award vests as follows: 50% vested on the grant date of April 25, 2016, and 50% will vest upon the occurrence of a Qualified Acquisition, as defined in the 2016 RSA.
- F3Represents (i) the 2014 RSA, (ii) 2016 RSA and (ii) a restricted stock award of 25,000 shares granted pursuant to the 2014 Equity Incentive Plan, which vest at a rate of 1/24 award shares per month beginning September 30, 2015, or upon a Qualified Transaction, as defined in the award.
- F4Excludes 50,000 shares of common stock held by US Commonwealth Life A.I. ("USCL"), of which Mohit Bhansali is Investment Manager and over whose securities he holds voting and dispositive power. USCL acquired these shares in a registered offering by the Issuer that closed on April 13, 2016.
- F5Represents an option award under the Issuer's 2016 Equity Incentive Plan. The options vest as follows: 50% vested on the grant date of April 25, 2016, and 50% vest upon the occurrence of a Qualified Acquisition, as defined in the award.