SEC Form 4 · accession 0001181431-15-008539
ReShape Lifesciences Inc. · RSLS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Carl Goldfischer
Director · 10% Owner
Period of report
May 6, 2015
Accepted (ET)
Jun 22, 2015 · 5:41 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001371217
Table I — non-derivative securities
No Table I lines on this filing.
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)F2,F1 | $1.12 | May 6, 2015 | A | 25,000 | A | — | May 6, 2025 | Common Stock | 25,000 | 87,498 | D |
| Stock Option (Right to Buy)F3 | $1.12 | May 6, 2015 | A | 25,000 | A | — | May 6, 2025 | Common Stock | 25,000 | 112,498 | D |
Explanation of responses
- F125% of the shares subject to the option are exercisable immediately. The remaining 75% of the shares subject to the option shall vest in a series of thirty-six (36) successive equal monthly installments upon completion of each month beginning on June 6, 2015 and ending on May 6, 2018.
- F2The amount of securities was erroneously reported in the Reporting Person's Form 4 filings between May 6, 2010 and May 15, 2014.
- F3100% of the shares subject to the option vest in successive installments of 1/12th per month beginning on June 6, 2015 and ending on May 6, 2016.