SEC Form 5 · accession 0001584927-15-000001
Omnitek Engineering Corp · OMTK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Alicia A Rolfe
Officer — CFO
Period of report
Dec 31, 2014
Accepted (ET)
Jan 16, 2015 · 4:38 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001404804
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | holding | — | — | — | 400 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock OptionF2 | $2.74 | holding | — | — | — | Sep 16, 2013 | Sep 15, 2020 | Common Stock | 100,000 | 100,000 | D |
Explanation of responses
- F1Does not include 800 shares held by her spouse; Mrs. Rolfe disclaims any beneficial ownership in such shares.
- F2One-forty eight (1/48) of the total number of shares subject to the Options shall vest and become exercisable at the end of each month following the Date of Grant on the same day of each month as the Date of Grant, so that all shares subject to the Options will be fully vested on the fourth anniversary of the Date of Grant.