SEC Form 4 · accession 0001140361-17-000265
LivaNova PLC · LIVN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Andre Michel Ballester
Officer — CEO
Period of report
Dec 31, 2016
Accepted (ET)
Jan 4, 2017 · 12:40 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001639691
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Ordinary SharesF1 | Dec 31, 2016 | M | 4,001 | — | A | 94,413 | D | |
| Ordinary SharesF3 | Dec 31, 2016 | F | 1,880 | $44.97 | D | 92,533 | D | |
| Ordinary SharesF1 | Dec 31, 2016 | M | 2,431 | — | A | 94,964 | D | |
| Ordinary SharesF4 | Dec 31, 2016 | F | 1,142 | $44.97 | D | 93,822 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF1,F2 | — | Dec 31, 2016 | M | 4,001 | D | — | — | Ordinary Shares | 4,001 | 0 | D |
| Restricted Stock UnitsF1,F2 | — | Dec 31, 2016 | M | 2,431 | D | — | — | Ordinary Shares | 2,431 | 0 | D |
Explanation of responses
- F1Each restricted stock unit ("RSU") represents a contingent right to receive one share of LivaNova PLC's ("Company") ordinary shares, ?1.00 par value.
- F2Reporting person was granted restricted stock units ("RSUs") under the Sorin LTI Award pursuant to the Sorin Plans. Each RSU represents a contingent right to receive one ordinary share of the Company. All of such RSUs vested and all restrictions thereon lapsed on December 30, 2016.
- F3The referenced shares were withheld from distribution at the request of reporting person. Such shares were forfeited and the associated value was used to offset the tax liability associated with the December 31, 2016 vesting of 4,001 RSUs.
- F4The referenced shares were withheld from distribution at the request of reporting person. Such shares were forfeited and the associated value was used to offset the tax liability associated with the December 31, 2016 vesting of 2,431 RSUs.