SEC Form 4 · accession 0001437749-15-009240
DETERMINE, INC. · DTRM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Blaine Mathieu
Officer — Chief Executive Officer · Director
Period of report
May 5, 2015
Accepted (ET)
May 7, 2015 · 1:11 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001090908
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | May 5, 2015 | P | 5,319 | $4.70 | A | 9,934 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant to Purchase Common StockF1 | $6.00 | May 5, 2015 | P | 2,659 | A | Nov 5, 2015 | Nov 5, 2020 | Common Stock | 2,659 | 189,638 | D |
Explanation of responses
- F1The Shares of Common Stock and the Warrant acquired directly by the Reporting Person and reported hereunder constitute a single unit, with a purchase price per share of Common Stock equal to $4.70.