SEC Form 4 · accession 0001567619-19-001732
PAVmed Inc. · PAVM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Matthew Sirovich
10% Owner
Period of report
Dec 27, 2018
Accepted (ET)
Jan 28, 2019 · 1:23 pm EST
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 | Dec 27, 2018 | J | 272,400 | — | A | 738,914 | D | |
| Common StockF1,F2 | Dec 27, 2018 | J | 60,000 | — | A | 792,000 | I | See Footnote |
| Common StockF3 | holding | — | — | — | 1,414,904 | I | See Footnote |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Securities of PAVMed Inc. (the "Issuer") acquired in settlement of all remaining accrued and unpaid interest outstanding under the Issuer's 15% Senior Secured Note due 2019 in connection with the repayment of such note.
- F2Securities of the Issuer held directly by The Boomer Fund, L.P. ("Boomer"). Mr. Sirovich is the general partner of Boomer and may be deemed to beneficially own the securities of the Issuer held by Boomer.
- F3Securities of the Issuer held directly by The Sirovich Family Charitable Foundation (the "Sirovich Foundation"). Matthew Sirovich is a Director and President of the Sirovich Foundation and may be deemed to beneficially own the securities of the Issuer held by the Sirovich Foundation.