SEC Form 3 · accession 0000899243-18-028765
VAPOTHERM INC · VAPO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David Blouin
Officer — Vice President, U.S. Sales
Period of report
Nov 13, 2018
Accepted (ET)
Nov 13, 2018 · 5:57 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001253176
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | holding | — | — | — | 32,440 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option to purchase Common StockF1 | $1.68 | holding | — | — | — | — | Jan 1, 2028 | Common Stock | 32,440 | — | D |
Explanation of responses
- F1The option vests and becomes exercisable as to 25% of the underlying shares on January 1, 2019 and the remaining 75% of the underlying shares in 36 equal monthly installments thereafter, subject to the Reporting Person's continuous employment with the Issuer through the relevant vesting dates.
Remarks
Exhibit List Exhibit 24 - Power of Attorney