SEC Form 4 · accession 0001615774-16-004149
Vivani Medical, Inc. · VANI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Gregg Williams
Director · 10% Owner
Period of report
Feb 8, 2016
Accepted (ET)
Feb 10, 2016 · 4:50 pm EST
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 STOCKF1 | Feb 8, 2016 | J | 4,358,082 | $3.37 | D | 0 | I | See footnote |
| COMMON STOCKF1,F2 | Feb 8, 2016 | J | 4,358,082 | $3.37 | A | 5,810,180 | I | See footnote |
| COMMON STOCKF3 | holding | — | — | — | 5,439 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WARRANTF1 | $5.00 | Feb 8, 2016 | J | 214,921 | D | Jul 31, 2012 | Jul 31, 2017 | COMMON STOCK | 214,921 | 0 | I |
| WARRANTF1 | $5.00 | Feb 8, 2016 | J | 214,921 | A | Jul 31, 2012 | Jul 31, 2017 | COMMON STOCK | 214,921 | 214,921 | I |
| WARRANTF2 | $5.00 | holding | — | — | — | Feb 23, 2013 | Feb 28, 2018 | COMMON STOCK | 240,000 | 240,000 | I |
Explanation of responses
- F1On February 8, 2016 Sam B. Williams Power Trust, a trust of which Mr. Williams is trustee and whose current life beneficiary is his mother and of which three trusts established for the benefit of Mr. Williams and his two siblings are remainder beneficiaries, sold (i) 4,358,082 shares of common stock and (ii) warrants to purchase 214,921 shares of common stock to Sam Williams Family Investments LLC, whose manager is Mr. Williams and whose owners are the three aforementioned trusts established for the benefit of Mr. Williams and his two siblings. Each trust owns 1/3 of Sam Williams Family Investments LLC. Mr. Williams exercises sole voting and dispositive power over the securities acquired by Sam Williams Family Investments LLC from the Sam B. Williams Power Trust and his total beneficial ownership remains unchanged as a result of this transaction.
- F2Williams International Co. LLC owns 1,452,098 shares and warrants to purchase 240,000 shares.
- F3Previously reported on Form 4, filed with the Commission on June 3, 2015.