SEC Form 4 · accession 0001437749-18-011319

Vivani Medical, Inc. · VANI

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

Reporting owner

Director · 10% Owner

Period of report

Jun 1, 2018

Accepted (ET)

Jun 5, 2018 · 9:00 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001266806

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F2	Jun 4, 2018	P	26,485	$1.945	A	26,319,121	I	See footnote
Common Stock^F4,F3	Jun 1, 2018	A	33,503	$0.00	A	26,352,624	I	See footnote

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Non Qualified Stock Option (right to buy)^F4	$2.05	Jun 2, 2018	A	25,970	A	Jun 2, 2019	Jun 2, 2028	Common Stock	25,970	25,970	D

F1Sam B Williams 95 GST Trust ("GST") acquired 26,485 shares of common stock on June 4, 2018. Mr. Williams is a trustee of GST.
F2Represents the weighted average price for the shares. The shares were purchased at prices ranging from $1.90 per share to $2.00 per share. The reporting person will provide to the Securities and Exchange Commission staff, the issuer, or any security holder of the issuer, upon request, full information regarding the number of shares purchased at each separate price.
F3After giving effect to the transactions reported on this Form 4, shares beneficially owned by Mr. Williams include (i) 15,625,639 shares of common stock and warrants to purchase 6,802,721 shares of common stock owned by GW Trust, (ii) 1,484,254 shares of common stock owned by Williams International Co. LLC, whose manager is Mr. Williams, (iii) 4,358,082 shares of common stock owned by Sam Williams Family Investments LLC, whose manager is Mr. Williams, and (iv) 4,884,649 shares of common stock owned by GST.
F4Awarded as compensation for serving on the Board of Directors and its committees.