SEC Form 4 · accession 0001209191-16-118165
ReShape Lifesciences Inc. · RSLS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mark B Knudson
Director
Period of report
May 4, 2016
Accepted (ET)
May 6, 2016 · 5:12 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 Stock | holding | — | — | — | 93 | I | Spouse Revocable Trust | |
| Common Stock | holding | — | — | — | 215 | I | Family Limited Partnership | |
| Common Stock | holding | — | — | — | 3,838 | I | Revocable Trust 2003 | |
| Common Stock | holding | — | — | — | 40,867 | D |
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 | 3,333 | A | May 4, 2016 | May 4, 2026 | Common Stock | 3,333 | 3,333 | D |
| Stock Option (right to buy)F1 | $41.40 | holding | — | — | — | — | Apr 20, 2016 | Common Stock | 451 | 451 | D |
| Stock Option (right to buy)F1 | $28.50 | holding | — | — | — | — | Oct 29, 2017 | Common Stock | 2,228 | 2,228 | D |
| Stock Option (right to buy)F1 | $28.50 | holding | — | — | — | — | Oct 29, 2017 | Common Stock | 1,726 | 1,726 | D |
| Stock Option (right to buy)F1 | $28.50 | holding | — | — | — | — | Oct 29, 2017 | Common stock | 2,942 | 2,942 | D |
| Stock Option (right to buy)F1 | $28.50 | holding | — | — | — | — | Oct 29, 2017 | Common Stock | 3,364 | 3,364 | D |
| Stock Option (right to buy)F1 | $56.70 | holding | — | — | — | — | Dec 31, 2018 | Common Stock | 1,388 | 1,388 | D |
| Warrant (common stock right to buy)F2,F3 | $32.85 | holding | — | — | — | — | — | Common Stock | 1,666 | 1,666 | D |
| Stock Option (right to buy)F1 | $38.70 | holding | — | — | — | — | Dec 31, 2018 | Common Stock | 23,333 | 23,333 | D |
| Stock Option (right to buy)F1 | $40.05 | holding | — | — | — | — | Dec 31, 2018 | Common Stock | 23,333 | 23,333 | D |
| Stock Option (right to buy)F1 | $28.50 | holding | — | — | — | — | Dec 31, 2018 | Common Stock | 13,333 | 13,333 | D |
| Stock Option (right to buy)F1 | $50.25 | holding | — | — | — | — | Dec 31, 2018 | Common Stock | 86,148 | 86,148 | D |
| Stock Option (right to buy)F1 | $19.65 | holding | — | — | — | — | Dec 31, 2018 | Common Stock | 85,248 | 85,248 | D |
| Stock Option (right to buy)F1 | $16.65 | holding | — | — | — | — | Dec 31, 2018 | Common Stock | 15,000 | 15,000 | D |
| Director Option (right to buy)F4 | $1.07 | holding | — | — | — | Feb 25, 2016 | Feb 25, 2026 | Common Stock | 3,333 | 3,333 | D |
Explanation of responses
- F1Options currently 100% vested.
- F2Warrant becomes exercisable 181 days from the date of issuance at close of offering.
- F3Warrant expires five years from the date it becomes exercisable.
- F4Vests immediately as to 25% on date noted and thereafter in cumulative installments of 1/36th per month.