SEC Form 4 · accession 0001140361-15-011730

Great Basin Scientific, Inc. · GBSN

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

David Spafford

Director

Period of report

Mar 11, 2015

Accepted (ET)

Mar 13, 2015 · 5:00 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001512138

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
Series E Convertible Preferred Stock^F3,F1,F2	—	Mar 11, 2015	P	7,450	A	—	—	Common Stock	29,800	7,450	I
Series E Convertible Preferred Stock^F4,F1,F2	—	Mar 12, 2015	P	10,000	A	—	—	Common Stock	40,000	17,450	I
Series E Convertible Preferred Stock^F5,F1,F2	—	Mar 13, 2015	P	3,300	A	—	—	Common Stock	13,200	20,750	I
Series C Common Stock Warrants^F3,F2	$2.55	Mar 11, 2015	P	59,600	A	—	Feb 25, 2020	Common Stock	59,600	59,600	I
Series C Common Stock Warrants^F4,F2	$2.55	Mar 12, 2015	P	80,000	A	—	Feb 25, 2020	Common Stock	80,000	139,600	I
Series C Common Stock Warrants^F5,F2	$2.55	Mar 13, 2015	P	26,400	A	—	Feb 25, 2020	Common Stock	26,400	166,000	I

Explanation of responses

F1Each share of Series E Convertible Preferred Stock is convertible into four shares of common stock and has no expiration date.
F2The Series E Convertible Preferred Stock is convertible, and the Series C Warrants are exercisable, upon the earlier of August 25, 2015 or the "Early Separation" of the Units. This Early Separation occurs if at any time after March 27, 2015 the closing price of our common stock is greater than $4.00 per share for 20 consecutive trading days, which we refer to as the "Separation Trigger Date". In the event of Early Separation, the Series E Convertible Preferred stock will become convertible, and the Series C Warrants will become exercisable, 15 days after the Separation Trigger Date.
F3The reported securities are included within 7,450 Units purchased by the reporting person for $9.2119 per Unit. Each Unit consists of one share of Series E Convertible Preferred Stock, which is convertible into four shares of common stock, and eight Series C Warrants.
F4The reported securities are included within 10,000 Units purchased by the reporting person for $9.8564 per Unit. Each Unit consists of one share of Series E Convertible Preferred Stock, which is convertible into four shares of common stock, and eight Series C Warrants.
F5The reported securities are included within 3,300 Units purchased by the reporting person for $10.20 per Unit. Each Unit consists of one share of Series E Convertible Preferred Stock, which is convertible into four shares of common stock, and eight Series C Warrants.