SEC Form 4 · accession 0001209191-17-009556
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
Feb 8, 2017
Accepted (ET)
Feb 10, 2017 · 4:37 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 StockF1 | holding | — | — | — | 143 | 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)F3 | $7.12 | Feb 8, 2017 | A | 93,250 | A | Feb 8, 2017 | Feb 8, 2027 | Common Stock | 93,250 | 93,250 | D |
| Stock Option (Right to Buy)F1,F2 | $91.70 | holding | — | — | — | Jan 19, 2017 | Jan 19, 2026 | Common Stock | 1,523 | 1,523 | D |
Explanation of responses
- F1On December 27, 2016, EnteroMedics Inc. effected a 1-for-70 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.
- F2Vests 25% one-year from the date of grant on the date noted and thereafter in cumulative installments of 1/36th per month.
- F3Vests immediately as to 25% on the date noted and thereafter in cumulative installments of 1/36th per month.
Remarks
EX 24: Ansari Power of Attorney Attached THIS FILING REFLECTS THE POST SPLIT NUMBERS OF ALL SHARES, OPTIONS AND SIMILAR INSTRUMENTS HELD BY THE REPORTING PERSON AS PREVIOUSLY REPORTED.