SEC Form 4 · accession 0001209191-15-078374

INSITE VISION INC · INSV

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

Reporting owner

Director

Period of report

Nov 2, 2015

Accepted (ET)

Nov 4, 2015 · 3:57 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.

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	D/I
Stock Option (right to buy)^F1	$0.52	Nov 2, 2015	D	30,000	D	Sep 23, 2009	Sep 23, 2018	Common Stock	30,000	D
Stock Option (right to buy)^F1	$0.38	Nov 2, 2015	D	150,000	D	Dec 16, 2010	Dec 16, 2019	Common Stock	150,000	D
Stock Option (right to buy)^F2	$0.33	Nov 2, 2015	D	150,000	D	Dec 20, 2011	Dec 20, 2020	Common Stock	150,000	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	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	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	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	D
Warrant (right to buy)^F3	$0.75	Nov 2, 2015	D	66,666	D	Jul 18, 2011	Jul 18, 2016	Common Stock	66,666	D
Warrant (right to buy)^F4	$0.33	Nov 2, 2015	D	287,357	D	Oct 9, 2014	Oct 9, 2019	Common Stock	287,357	D
Warrant (right to buy)^F5	$0.26	Nov 2, 2015	D	362,319	D	Dec 10, 2014	Dec 10, 2019	Common Stock	362,319	D
Warrant (right to buy)^F6	$0.18	Nov 2, 2015	D	444,445	D	Apr 17, 2015	Apr 17, 2020	Common Stock	444,445	D

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.
F3This warrant was cancelled in connection with the Merger in exchange for a cash payment of $0.04 per share underlying the warrant equal to the Black Scholes Value of the warrant on the date of the Merger.
F4This warrant was cancelled in connection with the Merger in exchange for a cash payment of $0.25 per share underlying the warrant equal to the Black Scholes Value of the warrant on the date of the Merger.
F5This warrant was cancelled in connection with the Merger in exchange for a cash payment of $0.27 per share underlying the warrant equal to the Black Scholes Value of the warrant on the date of the Merger.
F6This warrant was cancelled in connection with the Merger in exchange for a cash payment of $0.29 per share underlying the warrant equal to the Black Scholes Value of the warrant on the date of the Merger.