SEC Form 4 · accession 0001213900-16-018722
Workhorse Group Inc. · WKHS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
H. Benjamin Samuels
Director
Period of report
Nov 18, 2016
Accepted (ET)
Nov 18, 2016 · 3:53 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001425287
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, $0.001 par value per shareF2 | Nov 18, 2016 | X | 47,604 | $5.28 | A | 762,532 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock Purchase WarrantF3,F2 | $5.28 | Nov 18, 2016 | X | 47,604 | D | Nov 9, 2015 | Nov 9, 2020 | Common Stock, Par Value | 47,604 | 237,467 | I |
| Stock OptionsF4 | $7.21 | holding | — | — | — | Aug 16, 2016 | Aug 16, 2021 | Common Stock, Par Value $0.001 | — | — | D |
| Stock OptionsF1 | $7.01 | holding | — | — | — | Dec 17, 2015 | Dec 17, 2020 | Common Stock, Par Value $0.001 | 50,000 | 50,000 | D |
| Common Stock Purchase WarrantF3,F2 | $5.28 | holding | — | — | — | Dec 4, 2015 | Dec 4, 2020 | Common Stock, Par Value $0.001 | 142,857 | 142,857 | I |
Explanation of responses
- F110,000 of the options vested on December 17, 2015 and 4,000 shall vest every six (6) months thereafter on June 30 and December 31.
- F2On November 9, 2015, Samuels 2012 Children's Trust UAD 10/28/12 (the "Trust") acquired a Stock Purchase Warrant to acquire 428,571 shares of common stock (the "Initial Warrant"). On December 4, 2015, the Trust acquired a Stock Purchase Warrant to acquire 142,857 shares of common stock. On January 5, 2016, convertible notes held by the Trust were automatically converted into 571,429 shares of common stock. Further, on September 14, 2016, the Trust exercised the Initial Warrant and received 143,500 shares of common stock for a purchase price of $757,680 or $5.28 per share and on November 18, 2016, the Trust exercised the Initial Warrant and received 47,604 shares of common stock for a purchase price of $251,349 or $5.28 per share
- F3H. Benjamin Samuels is a trustee and beneficiary of the Trust
- F42,500 of the options vested on August 16, 2016 and an additional 2,500 will vest every six months thereafter.