SEC Form 5 · accession 0001594062-18-000025
Rafina Innovations Inc. · VICA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sergios Katsaros
Officer — Vice President
Period of report
Dec 31, 2017
Accepted (ET)
Feb 1, 2018 · 4:16 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001402737
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common stockF1 | Mar 1, 2017 | A | 100,000 | $0.845 | A | 300,000 | D | |
| Common stockF2 | Mar 17, 2017 | A | 1,000,000 | $0.17 | A | 1,300,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock awardF3 | — | Mar 1, 2017 | J | 100,000 | D | — | — | Common Stock | 100,000 | 0 | D |
Explanation of responses
- F1On March 1, 2017 the vesting conditions of a previously issued stock award for the Reporting Person was met, and the Issuer approved the issuance of 100,000 common shares as compensation for services provided by the Reporting Person. The price is the closing bid of the stock on the date of the original Grant Notice on March 1, 2016. The shares were issued on March 1, 2017.
- F2On March 17, 2017 the Reporting Person was issued a fully vested Stock Award for 1,000,000 shares of common stock with a market price of $0.17 on the date of issue.
- F3On March 1, 2016 (the "Grant Date"), the Issuer approved the grant of a stock award of 300,000 common shares as compensation for services provided by the Reporting Person. The awards vest as to 100,000 common shares on Grant Date; 100,000 common shares on the 6 month anniversary of Grant Date; and 100,000 common shares on the 12 month anniversary of Grant Date. The price is the closing bid of the Issuer's stock on the Grant Date, $0.845 per share.