SEC Form 4 · accession 0000741815-17-000069
HOOPER HOLMES INC · HPHW
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Steven R Balthazor
Officer — Chief Financial Officer
Period of report
Aug 10, 2017
Accepted (ET)
Sep 6, 2017 · 5:10 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000741815
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Options (Right to Buy)F1,F2 | $0.65 | Aug 10, 2017 | A | 125,000 | A | — | May 11, 2027 | Common Stock | 125,000 | 125,000 | D |
| Stock Options (Right to Buy)F1,F3 | $0.65 | Aug 10, 2017 | A | 125,000 | A | — | May 11, 2027 | Common Stock | 125,000 | 125,000 | D |
Explanation of responses
- F1As previously reported in the Company's proxy statement filed on June 29, 2017, the Company awarded these options to the reporting person at closing of the Company's merger with Provant Health Solutions, LLC on May 11, 2017, subject to approval by the Company's shareholders of an amendment to the plan under which the options were granted. The Company's shareholders approved the plan amendment at the Company's annual meeting held on August 10, 2017.
- F2Shares subject to this option vest in 25% tranches on each of the first, second, third and fourth anniversaries of the grand date of May 11, 2017.
- F3Shares subject to this option vest and become exercisable only if the Company achieves certain run rate synergies for the calendar year ending December 31, 2017.