SEC Form 4 · accession 0000904454-17-000535
REVA Medical, Inc. · RVA:AX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Brian H Dovey
Director
Period of report
Jul 25, 2017
Accepted (ET)
Jul 27, 2017 · 4:17 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001496268
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jul 25, 2017 | J | 5,000 | $0.00 | D | 18,500 | D | |
| Common StockF1,F2 | Jul 25, 2017 | J | 5,000 | $0.00 | A | 12,500 | I | By Domain Associates, LLC |
| Common StockF2 | holding | — | — | — | 3,606,002 | I | By Domain Partners V, L.P. | |
| Common StockF2 | holding | — | — | — | 85,186 | I | By DP V Associates, L.P. |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1An award of 10,000 Restricted Stock Units was made to the Reporting Person in May 2016, which vested in May 2017. Pursuant to the limited liability company agreement of Domain Associates, LLC, 50% of the vested shares subject to this award were transferred to Domain Associates, LLC.
- F2The Reporting Person is a Managing Member of One Palmer Square Associates V, LLC, which is the sole general partner of Domain Partners V, L.P. and DP V Associates, L.P., and a Managing Member of Domain Associates, LLC. The Reporting Person has elected to report as indirectly beneficially owned the entire number of securities beneficially owned by each such entity. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him.