SEC Form 4 · accession 0001645383-17-000022
MoSys, Inc. · MOSY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Stephen L Domenik
Director
Period of report
Oct 13, 2017
Accepted (ET)
Oct 16, 2017 · 3:48 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000890394
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option to purchase common stockF1 | $5.30 | Oct 13, 2017 | J | 4,000 | D | — | Jul 22, 2022 | Common Stock | 4,000 | 0 | D |
| Option to purchase common stockF2 | $17.00 | Oct 13, 2017 | J | 4,000 | D | — | Jul 16, 2021 | Common Stock | 4,000 | 0 | D |
| Option to purchase common stockF3 | $31.00 | Oct 13, 2017 | J | 4,000 | D | — | Jul 18, 2020 | Common Stock | 4,000 | 0 | D |
| Option to purchase common stockF4 | $41.90 | Oct 13, 2017 | J | 4,000 | D | — | Jul 18, 2019 | Common Stock | 4,000 | 0 | D |
| Option to purchase common stockF5 | $30.90 | Oct 13, 2017 | J | 12,000 | D | — | Jul 19, 2018 | Common Stock | 12,000 | 0 | D |
| Option to purchase common stockF6 | $30.90 | Oct 13, 2017 | J | 2,000 | D | — | Jul 19, 2018 | Common Stock | 2,000 | 0 | D |
Explanation of responses
- F1On October 13, 2017, the reporting person and the Company agreed to cancel a stock option granted on July 22, 2016 to purchase 4,000 shares of common stock. The option was previously reported on a Form 4 filed with the SEC on July 26, 2016. The canceled option was exercisable in full as of July 22, 2017 . Shares and price have been adjusted for to reflect 1-for-10 reverse stock split effected in February 2017.
- F2On October 13, 2017, the reporting person and the Company agreed to cancel a stock option granted on July 16, 2015 to purchase 4,000 shares of common stock. The option was previously reported on a Form 4 filed with the SEC on July 20, 2015. The canceled option was exercisable in full as of July 16, 2016. Shares and price have been adjusted for to reflect 1-for-10 reverse stock split effected in February 2017.
- F3On October 13, 2017, the reporting person and the Company agreed to cancel a stock option granted on July 18, 2014 to purchase 4,000 shares of common stock. The option was previously reported on a Form 4 filed with the SEC on July 22, 2014. The canceled option was exercisable in full as of July 18, 2015 . Shares and price have been adjusted for to reflect 1-for-10 reverse stock split effected in February 2017.
- F4On October 13, 2017, the reporting person and the Company agreed to cancel a stock option granted on July 18, 2013 to purchase 4,000 shares of common stock. The option was previously reported on a Form 4 filed with the SEC July 19, 2013. The canceled option was exercisable in full as of July 18, 2014 . Shares and price have been adjusted for to reflect 1-for-10 reverse stock split effected in February 2017.
- F5On October 13, 2017, the reporting person and the Company agreed to cancel a stock option granted on July 19, 2012 to purchase 12,000 shares of common stock. The option was previously reported on a Form 4 filed with the SEC on July 20, 2012. The canceled option was exercisable in full as of July 19, 2013. Shares and price have been adjusted for to reflect 1-for-10 reverse stock split effected in February 2017.
- F6On October 13, 2017, the reporting person and the Company agreed to cancel a stock option granted on July 19, 2012 to purchase 2,000 shares of common stock. The option was previously reported on a Form 4 filed with the SEC on July 20, 2012. The canceled option was exercisable in full as of July 19, 2013 . Shares and price have been adjusted for to reflect 1-for-10 reverse stock split effected in February 2017.