SEC Form 4 · accession 0001076542-17-000011
NEXEON MEDSYSTEMS INC · NXNN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
A later amendment supersedes this filing — read the amendment. The figures below are kept as originally reported (version chain, not an overwrite).
Reporting owner
William Rosellini
Officer — CHIEF EXECUTIVE OFFICER · Director · 10% Owner
Period of report
Sep 15, 2016
Accepted (ET)
Jan 9, 2017 · 12:48 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001416172
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF2,F1 | Sep 15, 2016 | J | 158,500 | $1.00 | D | 12,582,807 | I | Shares owned by Rosellini Scientific LLC |
| Common StockF3,F1 | Sep 15, 2016 | J | 39,000 | $0.50 | D | 12,543,807 | I | Shares owned by Rosellini Scientific LLC |
| Common StockF4 | Dec 15, 2016 | J | 2,979,000 | — | A | 2,979,000 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Rosellini Scientific LLC ("RS") is wholly-owned by William Rosellini. Mr. Rosellini has the power to vote and dispose of shares held by RS.
- F2Rosellini Scientific transferred 158,500 shares of the Company's common stock upon conversion of a $150,000 loan pursuant to a Debt Conversion Agreement dated September 15, 2016.
- F3Rosellini Scientific transferred 39,000 shares of the Company's common stock upon conversion of a $19,470 debt pursuant to a Conversion Agreement dated September 15, 2016.
- F4Pursuant to the terms of a License Agreement, Mr. Rosellini sold, assigned and transferred any and all of his right, title and interest in and to the License owned by him related to the certain patents to the Company pursuant to the Patent License Asset Purchase Agreement (the "Purchase Agreement") filed as Exhibit 10.1 to the Company's Form 8-K Current Report filed with the SEC on December 20, 2016. As consideration for the transfer of the patents and the License related thereto, the Company paid to Mr. Rosellini the sum of $3,119,000 in the form of $140,000 in cash and 2,979,000 shares of the Company's restricted Common Stock. These shares shall be restricted from transfer by Mr. Rosellini for a period of six months, as required by SEC Rule 16(b)-3.