SEC Form 4 · accession 0001493152-17-012780
POLARITYTE, INC. · PTE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jeffrey Hansen Dyer
Director
Period of report
Nov 10, 2017
Accepted (ET)
Nov 13, 2017 · 6:31 am EST
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 $0.001 per shareF1,F2,F3 | Nov 10, 2017 | A | 5,000 | $0.00 | A | 5,328 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OptionF4,F5,F6 | $24.59 | Nov 10, 2017 | A | 5,000 | A | — | Nov 10, 2027 | Common Stock | 5,000 | 416 | D |
Explanation of responses
- F1Represents a restricted stock award under the PolarityTE, Inc. 2017 Equity Incentive Plan (the "Restricted Stock Award"), which shall vest in twenty four (24) equal monthly installments on the one month anniversary of the grant date.
- F2Restricted Stock Award is issued as a performance award for the Reporting Person's service as a director of the Issuer.
- F3Includes shares vested or to be vested within 60 days pursuant to the Restricted Stock Award.
- F4Represents an option award under the PolarityTE, Inc. 2017 Equity Incentive Plan (the "Option Award"), which shall vest in twenty four (24) equal monthly installments on the one month anniversary of the grant date.
- F5Option Award is issued as a performance award for the Reporting Person's service as a director of the Issuer.
- F6Includes options vested or to be vested within 60 days pursuant to the Option Award.