SEC Form 4 · accession 0001144204-17-003248
XWELL, Inc. · XWEL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jason Charkow
Officer — VP Legal & Business Affairs
Period of report
Jan 17, 2017
Accepted (ET)
Jan 20, 2017 · 5:35 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001410428
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Jan 17, 2017 | A | 58,962 | $0.00 | A | 58,962 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionF3 | $2.12 | Jan 17, 2017 | A | 150,000 | A | — | Jan 17, 2027 | Common Stock | 150,000 | 150,000 | D |
Explanation of responses
- F1Represents 58,962 shares of restricted stock which vest on the first anniversary of the grant date.
- F2Includes 58,962 shares of unvested restricted stock units.
- F3These options to purchase shares of common stock of the Issuer vest in equal quarterly installments over a one-year period, with one-fourth vesting on the date of grant and one-fourth vesting at the end of each fiscal quarter thereafter.