SEC Form 4 · accession 0001246360-18-002042
IMPINJ INC · PI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Tom A Alberg
Director
Period of report
Jun 14, 2018
Accepted (ET)
Aug 15, 2018 · 9:49 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001114995
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| COMMON STOCKF3 | Jun 14, 2018 | M | 2,023 | $0.00 | A | 112,792 | D | |
| COMMON STOCKF1 | holding | — | — | — | 4,817 | I | By Alberg Family Investments LLC | |
| COMMON STOCKF2 | holding | — | — | — | 31,219 | I | By Raven Trust Fund |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RESTRICTED STOCK UNITS - 2017F4,F5 | — | Jun 14, 2018 | M | 2,023 | D | — | — | COMMON STOCK | 2,023 | 0 | D |
| RESTRICTED STOCK UNITS - 2018F4,F6 | — | Aug 13, 2018 | A | 4,754 | A | — | — | COMMON STOCK | 4,754 | 4,754 | D |
Explanation of responses
- F1Shares held of record by the Alberg Family Investments LLC. Mr. Alberg shares voting and dispositive control over such shares but disclaims beneficial ownership over such shares.
- F2Shares held of record by Raven Trust Fund. Mr. Alberg shares voting and dispositive control over such shares but disclaims beneficial ownership over such shares.
- F3Restricted stock units convert to common stock on a one-to-one basis.
- F4Each restricted stock unit represents a contingent right to receive one share of Impinj common stock.
- F5On June 14, 2017, the reporting person was granted 2023 restricted stock units ("RSUs"). These RSUs fully vested on June 14, 2018.
- F6The restricted stock units will fully vest on August 13, 2019.