SEC Form 4 · accession 0001209191-15-023046
INVACARE CORP · IVC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Aaron Malachi Mixon III
Director
Period of report
Mar 3, 2015
Accepted (ET)
Mar 5, 2015 · 5:25 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000742112
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF1 | Mar 3, 2015 | A | 4,254 | $0.00 | A | 4,254 | D | |
| Common Shares | holding | — | — | — | 276,861 | D | ||
| Common SharesF2 | holding | — | — | — | 87,141 | I | By Spouse | |
| Common SharesF2,F3 | holding | — | — | — | 69,446 | I | By GRAT | |
| Common SharesF4 | holding | — | — | — | 19,019 | I | By Invacare Retirement Savings Plan | |
| Class B Common Shares | holding | — | — | — | 129,397 | D | ||
| Class B Common SharesF5 | holding | — | — | — | 230,049 | I | By GRAT | |
| Class B Common SharesF2 | holding | — | — | — | 183,863 | I | By Spouse | |
| Class B Common SharesF2,F3 | holding | — | — | — | 160,603 | I | By GRAT |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F7,F6 | — | holding | — | — | — | — | — | Common Shares | 734,475 | 734,475 | D |
Explanation of responses
- F1Restricted stock units granted pursuant to the Invacare Corporation 2013 Equity Compensation Plan in an exempt transaction under Rule 16b-3. These restricted stock units vest in full on May 15, 2018 after a three-year "cliff" vesting period.
- F2The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
- F3Owned by Trustee for the 2012 Grantor Retained Annuity Trust created by the reporting person's spouse.
- F4Owned by the Trustee for the Invacare Retirement Savings Plan. The information given is based on a Plan Statement of December 31, 2014, the most recent information reasonably available.
- F5Owned by the Trustee for the 2012 Grantor Retained Annuity Trust created by the reporting person.
- F6No transaction is being reported on this line. Reported on a previously filed Form 3, Form 4, or Form 5.
- F7The reporting person holds previously reported options to buy 734,475 Common Shares (with tandem tax withholding rights) under the Invacare Corporation 2003 Performance Plan, granted in reliance upon the exemption provided by Rule 16b-3. All options were granted between September 8, 2005 and March 18, 2013, at exercise prices between $13.37 to $41.87 per share, will expire between September 8, 2015 and March 18, 2023, and became exercisable between September 30, 2006 and March 31, 2014.