SEC Form 4 · accession 0001209191-16-092916
ReShape Lifesciences Inc. · RSLS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Naqeeb A. Ansari
Officer — SVP of Sales
Period of report
Jan 19, 2016
Accepted (ET)
Jan 21, 2016 · 5:01 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001371217
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | holding | — | — | — | 10,000 | D |
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 | $1.31 | Jan 19, 2016 | A | 106,667 | A | Jan 19, 2017 | Jan 19, 2026 | Common Stock | 106,667 | 106,667 | D |
Explanation of responses
- F1Vests 25% one-year from the date of grant on the date noted and thereafter in cumulative installments of 1/36th per month.