SEC Form 4 · accession 0001209191-15-050210
REVA Medical, Inc. · RVA:AX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert Bernard Stockman
Officer — Chairman and CEO · Director
Period of report
Jun 3, 2015
Accepted (ET)
Jun 4, 2015 · 5:58 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,F2 | Jun 3, 2015 | P | 6,250 | $4.00 | A | 249,313 | D | |
| Common Stock | holding | — | — | — | 227,718 | I | By wife | |
| Common StockF3 | holding | — | — | — | 1,341,175 | I | Group Outcome Investors I, LLC | |
| Common StockF4 | holding | — | — | — | 1,101,615 | I | Kenneth Rainin Administrative Trust U/D/T 3/29/90 |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Represents the purchase of 62,500 of the Company's Chess Depository Interests (CDIs), trading on the Austrialian Securities Exchange.
- F2The purchase was executed in the form of CDIs, trading on the Austrialian Securities Exchange, and as such the purchase price has been converted to a USD equivalent, adjusting for the conversion ratio of 1 share of common stock per 10 CDIs, and the exchange rate on the date of the transaction.
- F3Represents shares held by Group Outcome Investors I, LLC. The members of Group Outcome Investors I, LLC are Isabel Stockman Trust, Martha Davis, Trustee; Hope Stockman Trust, Martha Davis, Trustee; Phoebe Stockman Trust, Martha Davis, Trustee; and Elizabeth Stockman Trust, Martha Davis, Trustee. Each of the members shares voting and dispositive power with respect to the shares. The trustees are children of Robert Stockman, our Chairman of the Board and Chief Executive Officer, and for Section 16 purposes, we have reported the full beneficial ownership of Group Outcome Investors I, LLC under Mr. Stockman's beneficial ownership. Mr. Stockman disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein.
- F4Mr. Stockman, along with Jennifer Rainin, is the trustee of the Kenneth Rainin Administrative Trust U/D/T 3/29/90 and has voting and dispositive power with respect to these shares. Mr. Stockman disclaims beneficial ownership except to the extent of his pecuniary interest therein.