SEC Form 4 · accession 0001493152-17-012291
Medovex Corp. · MDVX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Scott Haufe
Director
Period of report
Oct 30, 2017
Accepted (ET)
Nov 1, 2017 · 6:38 pm EDT
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,F3,F4,F5 | Oct 30, 2017 | A | 12,821 | $1.17 | A | 1,031,782 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The Reporting Person was granted 12,821 shares of common stock in lieu of cash fees that were due to the Reporting Person as of September 30, 2017 for his board services. The number of shares issued is based on the accrued but unpaid director fees owed to the Reporting Person during the nine months ended 2017, divided by the average closing price of the Issuer's common stock during the nine months ended 2017.
- F2Includes 275,612 shares of common stock held by Haufe Family Limited Partnership. The Reporting Person disclaims beneficial ownership of these shares.
- F3Includes 532,335 shares held by Morgan Stanley Smith Barney custodian for Nicole Haufe Roth IRA. The Reporting Person disclaims beneficial ownership of these shares.
- F4Includes 209,275 shares held directly by the Reporting Person's spouse. The Reporting Person disclaims beneficial ownership of these shares.
- F5Includes 21,739 shares granted to the Reporting Person on January 17, 2017 in lieu of cash fees that were due to the Reporting Person for his board services during fiscal years 2015 and 2016.