SEC Form 4 · accession 0001354488-17-000014
Pharma-Bio Serv, Inc. · PBSV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kirk Wheeler Michel
Director
Period of report
Dec 29, 2016
Accepted (ET)
Jan 3, 2017 · 6:46 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001304161
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Dec 29, 2016 | M | 10,000 | $0.70 | A | 25,541 | D | |
| Common StockF1 | Dec 29, 2016 | F | 7,778 | $0.90 | D | 17,763 | D | |
| Common StockF2 | holding | — | — | — | 340,706 | I | By Kema Advisors, Inc. |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionF3 | $0.70 | Dec 29, 2016 | M | 10,000 | D | — | Jan 2, 2017 | Common Stock | 10,000 | 0 | D |
Explanation of responses
- F1Represents the aggregate amount of shares of Common Stock withheld for a cashless exercise.
- F2The reporting person is the sole shareholder of this entity.
- F3The option vested in two equal installments on July 3, 2012 and July 3, 2013.