SEC Form 4 · accession 0001615594-17-000077
MGC DIAGNOSTICS Corp · MGCD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Hendrik Struik
Director
Period of report
Dec 28, 2017
Accepted (ET)
Dec 29, 2017 · 2:12 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000815093
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Dec 28, 2017 | U | 3,569 | $11.03 | D | 0 | D | |
| Common StockF1 | Dec 28, 2017 | U | 62,934 | $11.03 | D | 0 | I | By Trust |
| Common StockF2 | Dec 28, 2017 | U | 5,053 | $11.03 | D | 0 | I | By Trust |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock GrantsF3 | $8.91 | Dec 28, 2017 | D | 3,591 | D | — | — | Common Stock | 3,591 | 0 | D |
Explanation of responses
- F1Shares held by the reporting person's spouse, Kim Struik, in the Kim Struik Trust.
- F2Shares held by reporting person in the Hendrik Struik Trust.
- F3The restricted stock was to vest on the earlier of March 22, 2018 or the date of the company's 2018 Annual Meeting of Shareholders. It was cancelled pursuant to the merger agreement between issuer, MGC Parent LLC and AC Breathe Merger Sub Inc. in exchange for a cash payout of $39,609.