SEC Form 5 · accession 0001615774-16-004233
Vivani Medical, Inc. · VANI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Aaron Mendelsohn
Director
Period of report
Dec 31, 2015
Accepted (ET)
Feb 16, 2016 · 9:26 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,F2,F3 | Dec 31, 2015 | G | 5,000 | $6.00 | D | 737,394 | I | Mendelsohn Family Enterprises LLC |
| COMMON STOCKF3 | holding | — | — | — | 26,785 | I | Mendelsohn Investment Services LLC | |
| COMMON STOCK | holding | — | — | — | 142,813 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WARRANTSF4 | $5.00 | holding | — | — | — | Jul 31, 2017 | Jul 31, 2017 | COMMON STOCK | 50,548 | 50,548 | I |
| WARRANTSF4 | $5.00 | holding | — | — | — | Feb 23, 2013 | Feb 28, 2018 | COMMON STOCK | 21,584 | 21,584 | I |
Explanation of responses
- F1Mendelsohn Enterprises LLC gifted 5,000 shares to The Maestro Foundation, a not-for-profit entity.
- F2Constitutes an average sale price of Company's shares on the day of the gift.
- F3Mr. Mendelsohn has voting and disposition power over these shares and may be deemed to be the beneficial owner thereof.
- F4Previously reported on Form 3 filed with the Commission on 11/18/2014.