SEC Form 4 · accession 0001437749-15-009352
DETERMINE, INC. · DTRM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael Brodsky
Officer — Chief Executive Officer · Director
Period of report
May 5, 2015
Accepted (ET)
May 7, 2015 · 6:22 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 StockF1 | May 5, 2015 | P | 31,914 | $4.70 | A | 78,343 | I | By Vajra fund I, L.P. |
| Common Stock | holding | — | — | — | 92,854 | 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 StockF2,F3 | $6.00 | May 5, 2015 | P | 15,957 | A | Nov 5, 2015 | Nov 2, 2020 | Common Stock | 15,957 | 39,171 | I |
| Stock Option (right to buy)F4,F5 | — | holding | — | — | — | — | — | Common Stock | — | 105,000 | D |
Explanation of responses
- F1Shares issued in the name of Vajra Fund I, L.P. The reporting person is the General Partner of Vajra Fund I, L.P.
- F2The Shares of Common Stock and the Warrant acquired indirectly by the Reporting Person and reported hereunder constitue a single unit, with a purchase prices per of Common Stock equal to $4.70.
- F3Issued in the name of Vajra Fund I, L.P. The reporting person is the General Partner of Vajra Fund I, L.P.
- F4Compromises Stock Options previously issued.
- F5Not Applicable