SEC Form 4 · accession 0001437749-16-042858
ULTRALIFE CORP · ULBI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Philip A Fain
Officer — CFO and Treasurer
Period of report
Nov 30, 2016
Accepted (ET)
Dec 2, 2016 · 10:40 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000875657
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock; $.10 par valueF1 | Nov 30, 2016 | M | 5,162 | $3.9085 | A | 66,448 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionsF2 | $3.9085 | Nov 30, 2016 | M | 33,000 | D | Nov 30, 2016 | Dec 4, 2016 | Common Stock | 33,000 | 0 | D |
Explanation of responses
- F1(1) Represents shares of common stock acquired by the Reporting Person upon exercise of options for 33,000 shares of common stock of the Company, net of 27,838 shares of common stock, retained by the Company at a price determined pursuant to the terms of the Company's 2004 Long Term Incentive Plan, in payment of the exercise price for the options and the Reporting Person's individual minimum statutory withholding tax obligation.
- F2(2) Represents exercise of options for 33,000 shares of common stock of the Company.