SEC Form 5/A · accession 0001547522-16-000227
OxySure Therapeutics, Inc. · OXYS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 5/A). It replaces an earlier filing for the same period.
Reporting owner
Julian T Ross
Officer — CEO · Director · 10% Owner
Period of report
Dec 31, 2015
Accepted (ET)
Mar 3, 2016 · 5:47 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001413797
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common stockF1 | Dec 31, 2015 | A | 500,000 | $0.20 | A | 672,324 | D | |
| Common stock | holding | — | — | — | 14,040,761 | I | Held by JTR Investments, Limited | |
| Common stock | holding | — | — | — | 172,324 | D | ||
| Common stock | holding | — | — | — | 400,000 | I | Held by The Ross Family Trust |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Options (right to buy)F5,F2,F3 | $0.20 | Dec 31, 2015 | A | 1,000,000 | A | Jan 1, 2016 | Jan 1, 2021 | Common stock | 1,000,000 | 2,417,488 | D |
| Options (right to buy)F2,F3,F4 | $0.25 | holding | — | — | — | Apr 5, 2014 | Dec 5, 2019 | Common stock | 1,417,488 | 1,417,488 | D |
Explanation of responses
- F1Restricted stock units (RSUs) pursuant to employment agreement dated 1/1/2015.
- F2Represents the earliest date(s) that any options became exercisable.
- F3Represents the latest date(s) that any vested options expire.
- F4Comprises vested options issued pursuant to various employment agreements and related amendments under the Company's 2004 Stock Option Plan.
- F5Comprises options issuable pursuant to employment agreement dated 1/1/2015.