SEC Form 5 · accession 0001378706-16-000168
AMERICAN DG ENERGY INC · ADGE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John Hatsopoulos
Officer — Co-Chief Executive Officer · Director
Period of report
Dec 31, 2015
Accepted (ET)
Feb 12, 2016 · 2:46 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001378706
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Dec 17, 2015 | G | 506,016 | $0.00 | D | 0 | I | Held in trust for the benefit of John N. Hatsopoulos and with John N. Hatsopoulos as the trustee. |
| Common StockF1 | Dec 17, 2015 | G | 600,000 | $0.00 | D | 529,797 | D | |
| Common StockF1,F2 | Dec 18, 2015 | G | 101,400 | $0.00 | D | 428,397 | D | |
| Common Stock | holding | — | — | — | 36,149 | I | Held by Mr. Hatsopoulos's Spouse | |
| Common StockF3 | holding | — | — | — | 50,000 | I | Owned by Pat Limited. |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 6% Senior Unsecured Convertible DebentureF4 | $2.11 | holding | — | — | — | May 23, 2011 | May 25, 2018 | Common Stock | 1,137,441 | 1,137,441 | D |
Explanation of responses
- F1Held by John N. Hatsopoulos and his wife Patricia L. Hatsopoulos, as joint tenants with rights of survivorship, each of whom share voting and investment power
- F2Mr. Hatsopoulos has sole voting and investment control over these shares.
- F3Held by Pat Limited, a company incorporated in the Commonwealth of The Bahamas controlled by John N. Hatsopoulos.
- F4Derivative security is a 6% Senior Unsecured Convertible Debentures Due 2018 in the principal amount of $2,400,000 with a conversion price of $2.11.