SEC Form 4 · accession 0001437749-16-043754

CATASYS, INC. · CATS

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — Chairman & CEO · Director · 10% Owner

Period of report

Dec 21, 2016

Accepted (ET)

Dec 23, 2016 · 4:25 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001136174

Table I — non-derivative securities

No Table I lines on this filing.

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Warrant to purchase^F1,F2	$1.10	Dec 15, 2016	J	1,022,835	A	Dec 15, 2016	Dec 15, 2021	Common Stock	1,022,835	1,022,835	I
Convertible Debenture^F3,F2	$1.10	Dec 15, 2016	J	2,557,088	A	Dec 15, 2016	Mar 15, 2017	Common Stock	2,557,088	2,557,088	I

F1On December 15, 2016, Catasys, Inc. ("Catasys") issued to Acuitas Group Holdings, LLC ("Acuitas") a warrant exercisable for 1,022,835 shares of Catasys common stock at an exercise price of $1.10 per share (the "Warrant"), subject to potential future adjustment pursuant to the terms of the Warrant. The Warrant was issued to Acuitas concurrently and in connection with a debt financing, pursuant to which Catasys issued to Acuitas an 8% senior convertible debenture dated as of December 15, 2016 (the "Convertible Debenture")
F2The reporting person is the Managing Director and 100% owner of Acuitas Group Holdings, LLC, and may be deemed to beneficially own or control the securities. The reporting person disclaims beneficial ownership of any such securities.
F3On December 15, 2016, Catasys issued the Convertible Debenture to Acuitas. At the option of the holder, the Convertible Debenture is convertible into 2,557,088 shares of common stock at an exercise price of $1.10 per share, subject to potential future adjustment pursuant to the terms of the Convertible Debenture.