SEC Form 5/A · accession 0001140361-16-069621
OXBRIDGE RE HOLDINGS Ltd · OXBR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 5/A). It replaces an earlier filing for the same period.
Reporting owner
Sanjay Madhu
Officer — CEO, President · Director
Period of report
Dec 11, 2015
Accepted (ET)
Jun 13, 2016 · 6:10 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001584831
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Ordinary SharesF1 | Jan 23, 2015 | A | 40,000 | $0.00 | A | 40,000 | D | |
| Ordinary SharesF3,F4 | Dec 11, 2015 | J | 15,235 | $0.00 | D | 0 | I | See Footnote |
| Ordinary SharesF3,F1,F5 | Dec 11, 2015 | J | 15,231 | $0.00 | A | 83,231 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Share Options (right to buy)F1,F6 | $6.00 | Jan 23, 2015 | A | 120,000 | A | — | Jan 23, 2025 | Ordinary Shares | 120,000 | 120,000 | D |
| WarrantsF3,F4,F7 | $7.50 | Dec 11, 2015 | J | 28,778 | D | — | Mar 31, 2019 | Ordinary Shares | 28,778 | 0 | I |
| WarrantsF3,F1,F5,F7 | $7.50 | Dec 11, 2015 | J | 28,768 | A | — | Mar 31, 2019 | Ordinary Shares | 28,768 | 98,768 | I |
| Share Options (right to buy)F1,F6 | $6.00 | Jan 16, 2016 | A | 25,000 | A | — | Jan 16, 2026 | Ordinary Shares | 25,000 | 25,000 | D |
| WarrantsF5,F7 | $7.50 | holding | — | — | — | — | May 31, 2018 | Ordinary Shares | 105,000 | 105,000 | I |
Explanation of responses
- F1This amended Form 4 is being filed to include transactions not yet reported and to correct the total number of ordinary shares and warrants held by Universal Finance and Investments, L.C.
- F2Restricted shares granted January 23, 2015 vest in increments of 6.25% each on a quarterly basis over a four-year period, commencing on the date granted, and continuing on April 1st, July 1st, October 1st and January 1st of each calendar year through to December 31, 2018.
- F3This transaction represents a change in the form of beneficial ownership as a result of a pro rata distribution of the ordinary shares and warrants held by Moksha Capital Partners Re (M) Ltd. to its beneficial owners.
- F4Shares were held in the name of Moksha Capital Partners Re (M) Ltd.
- F5Shares indirectly held in the name of Universal Finance and Investments, L.C. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of the reporting person's pecuniary interest in such securities.
- F6These share options vest in increments of 6.25% each on a quarterly basis over a four-year period, commencing on the date granted, and continuing on April 1st, July 1st, October 1st and January 1st of each calendar year through to December 31, 2018.
- F7Immediately exercisable.