SEC Form 4 · accession 0001615774-17-001109

Vivani Medical, Inc. · VANI

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

Reporting owner

Director · 10% Owner

Period of report

Mar 14, 2017

Accepted (ET)

Mar 16, 2017 · 8:30 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	Mar 14, 2017	A	6,802,721	$1.47	A	15,367,848	I	See footnote
COMMON STOCK	holding	—	—		—	16,786	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Warrant to Purchase Common Stock^F1,F2	$1.47	Mar 14, 2017	A	6,802,721	A	Mar 14, 2017	Mar 14, 2022	COMMON STOCK	6,802,721	6,802,721	I
Warrant to Purchase Common^F2	$5.00	holding	—	—	—	Jul 31, 2012	Jul 31, 2017	COMMON STOCK	214,921	214,921	I
Warrant to Purchase Common^F2	$5.00	holding	—	—	—	Feb 23, 2013	Feb 28, 2018	COMMON STOCK	240,000	240,000	I

F1Gregg Williams 2006 Trust, a trust of which Mr. Williams is trustee, acquired common stock and warrants reported on this Form 4 pursuant to an exercise of subscription rights previously distributed by the Company to all holders of the Company's common stock. Each stockholder received a right to invest $0.47 for every share held of record on February 10, 2017, the record date, to purchase units consisting of one share of common stock and one warrant to purchase one share of common stock. The final allocations of units were confirmed on March 14, 2017.
F2Of which (i) Gregg Williams 2006 Trust, owns 9,525,512 shares and warrants to purchase 6,802,721 shares, (ii) Williams International Co. LLC, whose manager is Mr. Williams, owns 1,484,254 shares and warrants to purchase 240,000 shares, and (iii) Sam Williams Family Investments LLC, whose manager is Mr. Williams, owns 4,358,082 shares and warrants to purchase 214,921 shares.

* Pursuant to Power-of-Attorney, attached as exhibit.