SEC Form 4 · accession 0001235802-16-000264
COGENTIX MEDICAL INC /DE/ · CGNT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Darin Hammers
Officer — Interim CEO and President
Period of report
Jun 29, 2016
Accepted (ET)
Jul 1, 2016 · 4:39 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000894237
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Jun 29, 2016 | A | 100,000 | $0.00 | A | 232,741 | D |
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)F3 | $1.03 | Jun 29, 2016 | A | 100,000 | A | — | Jun 28, 2023 | Common Stock | 100,000 | 100,000 | D |
Explanation of responses
- F1These shares will be issued over time upon vesting pursuant to a restricted stock grant.
- F2Includes 175,716 shares that will be issued over time upon vesting pursuant to restrictive stock grants.
- F3This option vests with respect to 33,333 shares on each of June 29, 2017 and June 29, 2018 and with respect to 33,334 shares on June 29, 2019.