SEC Form 4 · accession 0001615774-17-006949

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

Nov 17, 2017

Accepted (ET)

Nov 21, 2017 · 7:44 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 STOCK^F1,F2	Nov 17, 2017	P	5,420	$1.1694	A	19,446,368	I	See footnote
COMMON STOCK^F3,F2	Nov 20, 2017	P	11,600	$1.1834	A	19,457,968	I	See footnote

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Warrant to Purchase Common^F2	$5.00	holding	—	—	—	Feb 23, 2013	Feb 28, 2018	COMMON STOCK	408,548	408,548	I
Warrant to Purchase Common^F2	$1.47	holding	—	—	—	Mar 13, 2017	Mar 13, 2022	COMMON STOCK	6,802,721	6,802,721	I

Explanation of responses

F1Sam B Williams 95 GST Trust, a trust of which Mr. Williams is trustee, acquired 5,420 shares of common stock reported on this Form 4 on November 17, 2017 at an average price of $1.1694 per share, in multiple open market transactions at prices ranging from $1.16 to $1.17 inclusive. The reporting person undertakes to provide the issuer or the staff of the SEC, upon request, full information regarding the number of shares acquired at each separate price.
F2Of which, (i) Gregg Williams 2006 Trust, a trust of which Mr. Williams is trustee, owned 13,598,612 shares of common stock and warrants to purchase 6,971,269 shares of common stock, (ii) Williams International Co. LLC, whose manager is Mr. Williams, owns 1,484,254 shares and warrants to purchase 240,000 shares, (iii) Sam Williams Family Investments LLC, whose manager is Mr. Williams, owns 4,358,082 shares and warrants to purchase 214,921 shares, and (iv) Sam B Williams 95 GST Trust, owned 5,420 and 17,020 shares common stock following November 17, 2017 and November 20, 2017 purchases respectively.
F3Sam B Williams 95 GST Trust, a trust of which Mr. Williams is trustee, acquired 11,600 shares of common stock reported on this Form 4 on November 20, 2017 at an average price of $1.1834 per share in multiple open market transactions at prices ranging from $1.17 to $1.20 inclusive. The reporting person undertakes to provide the issuer or the staff of the SEC, upon request, full information regarding the number of shares acquired at each separate price.