SEC Form 4 · accession 0001615774-17-001614

Vivani Medical, Inc. · VANI

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

Reporting owner

Director · 10% Owner

Period of report

Apr 7, 2017

Accepted (ET)

Apr 10, 2017 · 9:41 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	Apr 7, 2017	P	4,000,000	$1.00	A	19,384,634	I	.

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Warrant to Purchase Common^F1,F2	$5.00	Apr 7, 2017	P	48,157	A	Jul 31, 2012	Jul 31, 2017	COMMON STOCK	48,157	263,078	I
Warrant to Purchase Common^F1,F2	$5.00	Apr 7, 2017	P	168,548	A	Feb 23, 2013	Feb 28, 2018	COMMON STOCK	168,548	408,548	I
Warrant to Purchase Common Stock^F2	$1.47	holding	—	—	—	Mar 13, 2017	Mar 13, 2022	COMMON STOCK	6,802,721	6,802,721	I

F1Gregg G. Williams 2006 Trust, a trust of which Mr. Williams is trustee, acquired common stock and warrants in a private transaction.
F2Of which (i) Gregg G. Williams 2006 Trust, owns 13,542,298 shares and warrants to purchase 7,019,426 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.