SEC Form 5/A · accession 0000906344-15-000004
TriVascular Technologies, Inc. · TRIV
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
Michael V. Chobotov
Officer — Chief Technology Officer
Period of report
Dec 31, 2014
Accepted (ET)
Feb 13, 2015 · 4:45 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001432732
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F1 | $8.93 | Nov 29, 2013 | A | 32,042 | A | Nov 1, 2014 | Nov 29, 2023 | Common Stock | 32,042 | 32,042 | D |
| Stock Option (right to buy)F2 | $8.93 | Nov 29, 2013 | A | 49,641 | A | Nov 29, 2013 | Nov 29, 2023 | Common Stock | 49,641 | 49,641 | D |
Explanation of responses
- F125% of the shares underlying the option are exercisable beginning on the one year anniversary of the vesting start date and in equal monthly installments thereafter over a four-year period.
- F250% of the shares underlying the option are fully vested with the balance vesting in equal monthly installments over a two year period.
Remarks
This Form 5 is being filed to report two pre-IPO option grants that were inadvertently omitted from the reporting person's Form 4 filed on April 17, 2014, though these option grants were included in the reporting person's Form 3.