SEC Form 4 · accession 0001437749-15-002664
COGENTIX MEDICAL INC /DE/ · CGNT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Lewis C Pell
Director · 10% Owner
Period of report
Jan 25, 2013
Accepted (ET)
Feb 13, 2015 · 4:30 pm EST
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 Stock, $0.01 Par Value per share | Feb 12, 2015 | P | 15,000 | $0.4647 | A | 8,898,740 | D | |
| Common Stock, $0.01 Par Value per share | Feb 11, 2015 | P | 20,000 | $0.4635 | A | 8,883,740 | D | |
| Common Stock, $0.01 Par Value per share | holding | — | — | — | 50,000 | I | By spouse | |
| Common Stock, $0.01 Par Value per share | holding | — | — | — | 43,500 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible Promissory Note | $1.20 | Jan 25, 2013 | J | 1,000,000 | A | Jan 25, 2013 | Sep 19, 2017 | Common Stock | 833,333 | 15,213,953 | D |
| Convertible Promissory Note | $1.20 | Mar 12, 2013 | J | 1,000,000 | A | Mar 12, 2013 | Sep 19, 2017 | Common Stock | 833,333 | 16,047,286 | D |
| Convertible Promissory Note | $1.20 | Apr 19, 2013 | J | 1,000,000 | A | Apr 19, 2013 | Sep 19, 2017 | Common Stock | 833,333 | 16,880,620 | D |
| Convertible Promissory Note | $1.20 | Jun 10, 2013 | J | 1,000,000 | A | Jun 10, 2013 | Sep 19, 2017 | Common Stock | 833,333 | 17,713,953 | D |
| Convertible Promissory Note | $1.20 | Jul 24, 2013 | J | 1,000,000 | A | Jul 24, 2013 | Sep 19, 2017 | Common Stock | 833,333 | 18,547,286 | D |
| Convertible Promissory Note | $0.89 | Oct 7, 2013 | J | 1,000,000 | A | Oct 7, 2013 | Sep 25, 2018 | Common Stock | 1,123,595 | 19,670,881 | D |
| Convertible Promissory Note | $0.89 | Nov 26, 2013 | J | 1,000,000 | A | Nov 26, 2013 | Sep 25, 2018 | Common Stock | 1,123,595 | 20,794,477 | D |
| Convertible Promissory Note | $0.89 | Jan 21, 2014 | J | 1,000,000 | A | Jan 21, 2014 | Sep 25, 2018 | Common Stock | 1,123,595 | 21,918,072 | D |
| Convertible Promissory Note | $0.89 | Mar 13, 2014 | J | 500,000 | A | Mar 13, 2014 | Sep 25, 2018 | Common Stock | 561,797 | 22,479,870 | D |
| Convertible Promissory Note | $1.11 | Jun 16, 2014 | J | 1,000,000 | A | Jun 16, 2014 | Jun 16, 2019 | Common Stock | 900,900 | 23,380,770 | D |
| Convertible Promissory Note | $1.11 | Aug 12, 2014 | J | 1,000,000 | A | Aug 12, 2014 | Jun 16, 2019 | Common Stock | 900,900 | 24,281,671 | D |
| Convertible Promissory Note | $1.11 | Oct 24, 2014 | J | 1,000,000 | A | Oct 24, 2014 | Jun 16, 2019 | Common Stock | 900,900 | 25,182,572 | D |
Explanation of responses
- F1The Issuer issued a $20.0 million revolving convertible promissory note to the Reporting Person on September 19, 2012 (the "2012 Note"). The Issuer borrowed an additional $1.0 million under the 2012 Note on January 25, 2013, March 12, 2013, April 19, 2013, June 10, 2013 and July 24, 2013, bring the aggregate principal amount outstanding under the 2012 Note to $20.0 million. The outstanding balance under the 2012 Note is convertible, at the Reporting Person's opinion, into shares of the Issuer's common stock at a fixed conversion price of $1.20 per share.
- F2The Issuer issued a $3.5 million revolving convertible promissory note to the Reporting Person on September 23, 2013 (the "2013 Note"). The Issuer borrowed $1.0 million under the 2013 Note on October 7, 2013. November 26, 2013 and January 21, 2014 and $500,000 under the 2013 Note on March 13, 2014, bring the aggregate principal amount outstanding under the 2013 Note to $3.5 million. The outstanding balance under the 2013 Note is convertible, at the Reporting Person's opinion, into shares of the Issuer's common stock at a fixed conversion price of $0.89 per share.
- F3The Issuer issued a $5.0 million revolving convertible promissory note to the Reporting Person on June 16, 2014 (the "2014 Note"). The Issuer borrowed $1.0 million under the 2014 Note on June 16, 2014, August 12, 2014 and October 24, 2014, bring the aggregate principal amount outstanding under the 2014 Note to $3.0 million. The outstanding balance under the 2014 Note is convertible, at the Reporting Person's opinion, into shares of the Issuer's common stock at a fixed conversion price of $1.11 per share