SEC Form 5 · accession 0000899243-19-002111

· DHR

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — Chairman of Exec. Committee · Director

Period of report

Dec 31, 2018

Accepted (ET)

Jan 29, 2019 · 4:16 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000313616

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock, par value $.001	Feb 2, 2018	G	150,000	$0.00	D	2,147,673	D
Common Stock, par value $.001	Feb 12, 2018	G	17,442	$0.00	D	2,130,231	D
Common Stock, par value $.001^F1	Feb 12, 2018	G	17,442	$0.00	A	692,151	I	Through the Mitchell P. Rales Family Trust
Common Stock, par value $.001	May 2, 2018	G	102,278	$0.00	D	2,027,953	D
Common Stock, par value $.001^F1	May 2, 2018	G	102,278	$0.00	A	794,429	I	Through the Mitchell P. Rales Family Trust
Common Stock, par value $.001	Jul 24, 2018	G	200,000	$0.00	D	1,827,953	D
Common Stock, par value $.001^F2	Oct 19, 2018	G	400,000	$0.00	D	3,427,953	D
Common Stock, par value $.001	Oct 25, 2018	G	200,000	$0.00	D	3,227,953	D
Common Stock, par value $.001	Nov 9, 2018	G	200,000	$0.00	D	3,027,953	D
Common Stock, par value $.001^F2,F3	holding	—	—		—	32,000,000	I	Through single-member LLCs
Common Stock, par value $.001^F4	holding	—	—		—	25,660	I	By Spouse
Common Stock, par value $.001^F5	holding	—	—		—	295	I	By daughter
Common Stock, par value $.001^F5	holding	—	—		—	295	I	By daughter
Common Stock, par value $.001	holding	—	—		—	193,431	I	By 401(k) Plan

No Table II lines on this filing.

F1The Reporting Person is the trustee of the Mitchell P. Rales Family Trust.
F2Total reflects a change in form of ownership pursuant to the exemption provided by Rule 16a-13 under the Securities Exchange Act of 1934, as amended.
F3The reported shares are held through single-member LLCs, of which a revocable trust with the Reporting Person as the sole trustee and beneficiary is the sole member of these LLCs.
F4The Reporting Person disclaims beneficial ownership of the shares held by his spouse, and this report should not be deemed an admission that the Reporting Person is the beneficial owner of his spouse's shares for purposes of Section 16 or for any other purpose.
F5The reported shares are held through custodial accounts for the benefit of the Reporting Person's daughter. The Reporting Person disclaims beneficial ownership of the shares held by his daughter, and this report should not be deemed an admission that the Reporting Person is the beneficial owner of his daughter's shares for purposes of Section 16 or for any other purpose.