SEC Form 4 · accession 0001251769-17-000085
Apollo Endosurgery, Inc. · APEN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David Pacitti
Director
Period of report
Dec 12, 2017
Accepted (ET)
Dec 13, 2017 · 5:27 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001251769
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common SockF1,F2 | Dec 12, 2017 | A | 3,337 | $0.00 | A | 3,337 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F1,F3 | $3.98 | Dec 12, 2017 | A | 15,154 | A | — | Dec 12, 2027 | Common Sock | 15,154 | 15,154 | D |
Explanation of responses
- F1Award is issued pursuant to the 2017 Equity Incentive Plan.
- F21/12th of the shares will vest on each one-month anniversary of December 12, 2017.
- F31/12th of the shares subject to the option will vest on each one-month anniversary of December 12, 2017.