SEC Form 4/A · accession 0001235802-15-000051
Kips Bay Medical, Inc. · KIPS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Scott Kellen
Officer — COO, CFO, VP of Finance & Secy
Period of report
Mar 10, 2015
Accepted (ET)
Apr 15, 2015 · 4:05 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001460198
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | holding | — | — | — | 20,000 | D |
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 | $0.25 | Mar 10, 2015 | A | 50,000 | A | Mar 10, 2016 | Mar 10, 2025 | Common Stock | 50,000 | 50,000 | D |
Explanation of responses
- F1This Form 4 has been amended to correct the exercise price. The exercise price previously reported on the original Form 4 was the closing price as quoted on the OTCQB and should have been the average of the closing bid and closing ask prices as reported on the OTCQB. At the time of the original filing, the average of the closing bid and closing ask prices as reported on the OTCQB was not available.