SEC Form 4 · accession 0001209191-15-042294

HTG MOLECULAR DIAGNOSTICS, INC · HTGM

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

Reporting owner

Officer — President & CEO · Director

Period of report

May 11, 2015

Accepted (ET)

May 13, 2015 · 4:30 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
Common Stock^F1	May 11, 2015	C	2,088	—	A	2,088	D
Common Stock^F1	May 11, 2015	C	2,174	—	A	4,262	D
Common Stock^F1	May 11, 2015	C	567	—	A	4,829	D
Common Stock^F1,F2	May 11, 2015	C	98	—	A	4,927	D
Common Stock	May 11, 2015	J	791	$0.00	A	5,718	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Series C-2 Convertible Preferred Stock^F1	—	May 11, 2015	C	221,631	D	—	—	Common Stock	2,088	0	D
Series D Convertible Preferred Stock^F1	—	May 11, 2015	C	233,495	D	—	—	Common Stock	2,174	0	D
Series E Convertible Preferred Stock^F1	—	May 11, 2015	C	60,910	D	—	—	Common Stock	567	0	D
Series D Convertible Preferred Stock Warrant (right to buy)^F2	—	May 11, 2015	X	10,544	D	Jul 30, 2010	Jul 29, 2020	Series D Convertible Preferred Stock	10,544	0	D
Series D Convertible Preferred Stock^F4	—	May 11, 2015	X	10,544	A	—	—	Common Stock	98	10,544	D
Series D Convertible Preferred Stock^F1	—	May 11, 2015	C	10,544	D	—	—	Common Stock	98	0	D

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.
F2The warrant was net exercised for shares of common stock upon the closing of the Issuer's initial public offering.
F3On 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.
F4The shares of Series D Convertible Preferred Stock have no expiration date and are convertible at any time at the election of the holder without payment of further consideration. Each share of Series D Convertible Preferred Stock will automatically convert on a 1 for 107.39 basis into shares of Common Stock upon the closing of the Issuer's initial public offering.