SEC Form 4 · accession 0001094891-16-000505
PAVmed Inc. · PAVM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Richard F Fitzgerald
Officer — CFO and Secretary
Period of report
Jun 1, 2016
Accepted (ET)
Jun 3, 2016 · 12:34 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001624326
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Jun 1, 2016 | P$0 | 200 | — | A | 200 | I | By NFS/FMTC IRA for the benefit of Richard Fitzgerald |
| Common StockF1 | holding | — | — | — | 100 | I | By custodial account for benefit of son |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantsF1,F2 | $5.00 | Jun 1, 2016 | A | 200 | A | Oct 28, 2016 | Jan 29, 2022 | Common Stock | 200 | 200 | I |
| WarrantsF1 | $5.00 | holding | — | — | — | Oct 28, 2016 | Jan 29, 2022 | Common Stock | 100 | 100 | I |
Explanation of responses
- F1Represents securities included within units, each unit comprised of one share of common stock and one warrant. Each warrant entitles the holder to purchase one share of the issuer's common stcok at an exercise price of $5.00 per share, subject to adjustment.
- F2The units were purchased at a price of $11.10 per unit.