SEC Form 4 · accession 0001209191-15-042279
HTG MOLECULAR DIAGNOSTICS, INC · HTGM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Debra A Gordon
Officer — V.P. and Chief Legal Counsel
Period of report
May 11, 2015
Accepted (ET)
May 13, 2015 · 4:26 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001169987
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | May 11, 2015 | C | 233 | — | A | 233 | D | |
| Common StockF1 | May 11, 2015 | C | 71 | — | A | 304 | D | |
| Common Stock | May 11, 2015 | J | 52 | $0.00 | A | 356 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series D Convertible Preferred StockF1 | — | May 11, 2015 | C | 25,124 | D | — | — | Common Stock | 233 | 0 | D |
| Series E Convertible Preferred StockF1 | — | May 11, 2015 | C | 7,646 | D | — | — | Common Stock | 71 | 0 | D |
Explanation of responses
- F1Automatic conversion, in connection with the Issuer's initial public offering, of preferred stock into shares of common stock on a 1 for 107.39 basis, after accounting for any applicable antidilution adjustments. The shares have no expiration date.
- F2On April 23, 2015, the Board of Directors of the Issuer declared a dividend payable to all holders of the Series D Convertible Preferred Stock and Series E Convertible Preferred Stock of the Issuer payable in the form of shares of Common Stock of the Issuer. The dividends were issued in connection with the closing of the Issuer's initial public offering.