SEC Form 4 · accession 0000950103-15-007488
Penumbra Inc · PEN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Adam Elsesser
Officer — Chairman, CEO and President · Director
Period of report
Sep 17, 2015
Accepted (ET)
Sep 17, 2015 · 7:31 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001321732
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jun 22, 2015 | M | 300,000 | $0.57 | A | 1,300,000 | D | |
| Common StockF1,F2 | Jun 22, 2015 | F | 64,162 | $14.46 | D | 1,235,838 | D | |
| Common StockF3 | holding | — | — | — | 673 | I | By Trust |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F1,F4 | $0.57 | Jun 22, 2015 | M | 300,000 | D | — | Mar 31, 2016 | Common Stock | 300,000 | 0 | D |
| Stock Option (right to buy)F5 | $30.00 | Sep 17, 2015 | A | 450,000 | A | — | Sep 16, 2025 | Common Stock | 450,000 | 450,000 | D |
Explanation of responses
- F1These transactions occurred prior to the date on which the Reporting Person became subject to Section 16 and were reflected on the Reporting Person's Form 3.
- F2Payment of exercise price and tax liability by delivering or withholding shares in accordance with Rule 16b-3.
- F3Shares are held by the Siegel/Elsesser Revocable Trust.
- F4All shares are fully vested.
- F5The original option grant vests over four years, with 25% of the shares vesting on September 17, 2016 and 1/48 vesting each month thereafter.