SEC Form 5 · accession 0001321732-18-000021
Penumbra Inc · PEN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sridhar Kosaraju
Officer — CFO and Head of Strategy
Period of report
Dec 31, 2017
Accepted (ET)
Feb 14, 2018 · 6:37 pm EST
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 StockF2 | Nov 22, 2017 | G | 1,000 | $0.00 | D | 54,147 | I | By Trust |
| Common StockF3,F4 | holding | — | — | — | 302,431 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1This was a bona fide gift with no payment in consideration.
- F2Shares are held by the Kosaraju Family Trust.
- F3The Reporting Person holds shares both directly and indirectly through his revocable family trust as indicated on this Form. Any changes between direct holdings and indirect holdings through such trust are in transactions exempt from Section 16 pursuant to Rule 16a-13 under the Securities Exchange Act of 1934 as mere changes in form of beneficial ownership.
- F4A portion of these shares is subject to vesting.