SEC Form 5 · accession 0001209191-19-014783
Everpure, Inc. · P
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David Hatfield
Officer — President
Period of report
Jan 31, 2019
Accepted (ET)
Feb 28, 2019 · 7:30 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001474432
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common Stock | Sep 10, 2018 | G | 18,130 | $0.00 | D | 415,622 | D | |
| Class A Common Stock | Sep 18, 2018 | M | 14,354 | $2.98 | A | 429,976 | D | |
| Class A Common Stock | Sep 18, 2018 | M | 99,891 | $2.575 | A | 529,867 | D | |
| Class A Common StockF1 | holding | — | — | — | 18,666 | I | By Trust | |
| Class A Common StockF2 | holding | — | — | — | 18,666 | I | By Trust | |
| Class A Common StockF3 | holding | — | — | — | 18,666 | I | By Trust | |
| Class A Common StockF4 | holding | — | — | — | 24,375 | I | By Trust |
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)F5 | $2.58 | Sep 18, 2018 | M | 99,891 | D | — | Jan 29, 2024 | Class A Common Stock | 99,891 | 300,109 | D |
| Stock Option (right to buy)F6 | $2.98 | Sep 18, 2018 | M | 14,354 | D | — | Mar 27, 2024 | Class A Common Stock | 14,354 | 485,646 | D |
Explanation of responses
- F1By DMH 2013 Irrevocable Trust
- F2By JHH 2013 Irrevocable Trust
- F3By KGH 2013 Irrevocable Trust
- F4By D M Hatfield & J M Hatfield Co-TTEE The Hatfield Family Trust U/A DTD 03/10/2000
- F5This option is fully vested.
- F61/24th of the total shares subject to the option vest in equal monthly installments one month from 1/1/2018. The option shall be subject to accelerated vesting as set forth in optionee's employment agreement with the Issuer.