SEC Form 4 · accession 0001415889-17-000265
Medovex Corp. · MDVX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Steve Gorlin
Director
Period of report
Feb 9, 2017
Accepted (ET)
Feb 14, 2017 · 7:49 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001591165
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Feb 9, 2017 | P | 144,230 | $1.04 | A | 1,340,020 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantsF3 | $1.50 | Feb 9, 2017 | P | 72,115 | A | Feb 9, 2017 | Feb 9, 2022 | Common Stock | 72,115 | 459,615 | D |
Explanation of responses
- F1The 144,231 shares were purchased as part of a private placement unit offering for $1.04 per unit, each unit consisting of one share of common stock and one-half of a warrant to purchase one share of common stock at an exercise price per share equal to $1.50 per share for a period of five (5) years.
- F2Includes 125,000 shares held by Mr. Gorlin's spouse, Deborah Gorlin. Mr. Gorlin disclaims beneficial ownership of Deborah Gorlin's shares.
- F3The warrants were purchased as part of a private placement unit offering for $1.04 per unit, each unit consisting of one share of common stock and one-half of a warrant to purchase one share of common stock at an exercise price per share equal to $1.50 per share for a period of five (5) years.