SEC Form 5 · accession 0001615774-17-000315
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, 2016
Accepted (ET)
Feb 1, 2017 · 8:40 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 | Sep 26, 2016 | G | 809,002 | $3.25 | D | 54,877 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantF3 | $5.00 | holding | — | — | — | Jul 31, 2012 | Jul 31, 2017 | Common Stock | 50,548 | 0 | I |
| WarrantF3 | $5.00 | holding | — | — | — | Feb 23, 2013 | Feb 28, 2018 | Common Stock | 21,684 | 0 | I |
Explanation of responses
- F1Mendelsohn Family Enterprises, LLC (MFE), a limited liability company that is 80% owned by Mr. Mendelsohn and 20% by Mr. Mendelsohn's two adult sons, transferred for no consideration 809,002 shares of the Company's common stock that it held of record, as a gift made in connection with estate planning, to Mendelsohn Investment Services LLC, a limited liability company wholly owned and managed by Mr. Mendelsohn's two adult sons.
- F2The closing price of Company's common stock on Nasdaq on the date of transfer.
- F3As previously reported on Form 3 filed with the Commission on November 19, 2014.