SEC Form 4 · accession 0001209191-16-118161
ReShape Lifesciences Inc. · RSLS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Anthony P. Jansz
Director
Period of report
May 4, 2016
Accepted (ET)
May 6, 2016 · 4:59 pm EDT
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 StockF1,F2 | holding | — | — | — | 1,667 | I | Family Trust | |
| Common StockF1,F3 | holding | — | — | — | 10,000 | I | Pibrac Property Holdings PTY |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Director Option (Right to Buy)F4 | $0.75 | May 4, 2016 | A | 3,000 | A | May 4, 2016 | May 4, 2026 | Common Stock | 3,000 | 3,000 | D |
| Director Option (right to buy)F1,F4 | $39.45 | holding | — | — | — | May 5, 2011 | May 5, 2021 | Common Stock | 1,666 | 1,666 | D |
| Director Option (right to buy)F1,F4 | $41.55 | holding | — | — | — | May 9, 2012 | May 9, 2022 | Common Stock | 666 | 666 | D |
| Stock Option (right to buy)F1,F5 | $39.75 | holding | — | — | — | Jan 22, 2013 | Jan 22, 2017 | Common Stock | 3,333 | 3,333 | D |
| WarrantsF1,F3 | $17.10 | holding | — | — | — | Feb 27, 2013 | Feb 27, 2018 | Common Stock | 4,000 | 4,000 | I |
| Director Option (right to buy)F1,F4 | $13.20 | holding | — | — | — | May 8, 2013 | May 8, 2023 | Common Stock | 666 | 666 | D |
| Option (right to buy)F1,F6 | $19.65 | holding | — | — | — | May 31, 2013 | May 31, 2017 | Common Stock | 3,333 | 3,333 | D |
| Director Option (right to buy)F1,F4 | $27.60 | holding | — | — | — | May 7, 2014 | May 7, 2024 | Common Stock | 1,666 | 1,666 | D |
| Performance Option (right to buy)F1,F7 | $17.10 | holding | — | — | — | Nov 14, 2014 | Oct 6, 2018 | Common Stock | 1,666 | 1,666 | D |
| Director Option (right to buy)F1,F4 | $16.80 | holding | — | — | — | May 6, 2015 | May 6, 2025 | Common Stock | 1,666 | 1,666 | D |
| Director Option (right to buy)F1,F8 | $16.80 | holding | — | — | — | Jun 6, 2015 | May 6, 2025 | Common Stock | 1,666 | 1,666 | D |
Explanation of responses
- F1On January 6, 2016, EnteroMedics Inc. effected a 1-for-15 reverse stock split of its issued and outstanding shares of common stock, par value $0.01 per share, resulting in a proportional decrease in the total shares of common stock beneficially owned by the reporting person. all previously reported exercise prices, option grants and similar instruments convertible into common stock were proportionally adjusted to reflect the reverse split.
- F2The reporting person disclaims beneficial interest in the shares held by the Trust.
- F3The reporting person disclaims beneficial interest in the shares, except to the extent of his pecuniary interest in such shares.
- F4Vests immediately as to 25% on date noted and thereafter in cumulative installments of 1/36th per month.
- F5Vests immediately as to 1,111 shares on the date noted; 1,111 shares on 1/22/2014 and 1,111 shares on 1/22/2015.
- F6Vests immediately as to 1,111 shares on the date noted; 1,111 shares on 5/31/2014 and 1,111 shares on 5/31/2015.
- F7On October 6, 2014, the reporting person was granted an option to purchase 1,666 shares of common stock upon the satisfaction of certain performance criteria prior to March 31, 2015. The performance criteria were met, resulting in vesting of the option in full.
- F8Vests in cumulative installments of 1/12th per month beginning the date shown.
Remarks
THIS FILING REFLECTS THE POST SPLIT NUMBERS OF ALL SHARES, OPTIONS AND SIMILAR INSTRUMENTS HELD BY THE REPORTING PERSON AS PREVIOUSLY REPORTED.