SEC Form 4 · accession 0001209191-15-078373
INSITE VISION INC · INSV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Brian Levy
Director
Period of report
Nov 2, 2015
Accepted (ET)
Nov 4, 2015 · 3:56 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000802724
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 Option (right to buy)F1 | $0.56 | Nov 2, 2015 | D | 56,250 | D | Sep 16, 2012 | Sep 16, 2021 | Common Stock | 56,250 | 0 | D |
| Stock Option (right to buy)F1 | $0.44 | Nov 2, 2015 | D | 150,000 | D | Dec 14, 2012 | Dec 14, 2021 | Common Stock | 150,000 | 0 | D |
| Stock Option (right to buy)F2 | $0.32 | Nov 2, 2015 | D | 150,000 | D | Dec 12, 2013 | Dec 12, 2022 | Common Stock | 150,000 | 0 | D |
| Stock Option (right to buy)F2 | $0.23 | Nov 2, 2015 | D | 150,000 | D | Dec 11, 2014 | Dec 11, 2023 | Common Stock | 150,000 | 0 | D |
| Stock Option (right to buy)F2 | $0.22 | Nov 2, 2015 | D | 150,000 | D | Dec 10, 2015 | Dec 10, 2024 | Common Stock | 150,000 | 0 | D |
Explanation of responses
- F1In accordance with the terms of the Agreement and Plan of Merger, dated September 15, 2015, as amended and restated, by and among Thea Acquisition Corp ("Purchaser"), Ranbaxy, Inc. and InSite Vision Incorporated ("Issuer") pursuant to which Purchaser was merged with and into Issuer (the "Merger"), this stock option was cancelled at the effective time of the Merger without consideration because the exercise price of the stock option equaled or exceeded $0.35 per share.
- F2This option was cancelled in connection with the Merger in exchange for a cash payment per share equal to the difference between $0.35 and the exercise price of the option.