SEC Form 5 · accession 0001437749-18-005158
COGENTIX MEDICAL INC /DE/ · CGNT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Howard I. Zauberman
Director
Period of report
Dec 31, 2015
Accepted (ET)
Mar 21, 2018 · 3:53 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000894237
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F1,F2 | $2.70 | Feb 2, 2015 | A | 20,000 | A | Feb 2, 2015 | Mar 30, 2018 | Common Stock | 20,000 | 20,000 | D |
Explanation of responses
- F1As a result of the merger between Uroplasty Inc. and Cogentix Medical, Inc., formerly Vision-Sciences, Inc. ("Cogentix"), the common stock of Cogentix split 1-for-5 resulting in a decrease in the number of options held by the reporting person. The reported option grant is adjusted to reflect the reverse split that occurred on March 31, 2015.
- F2The initial expiration date of the option grant was changed as a result of the merger.