SEC Form 4 · accession 0001140361-17-010823
USA TECHNOLOGIES INC · USAT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Albin F Moschner
Director
Period of report
Mar 6, 2017
Accepted (ET)
Mar 7, 2017 · 12:57 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000896429
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Aug 16, 2016 | G | 4,000 | $0.00 | D | 413,762 | D | |
| Common Stock | Aug 18, 2016 | G | 4,000 | $0.00 | D | 409,762 | D | |
| Common StockF1 | Mar 6, 2017 | P | 15,000 | $3.858 | A | 424,762 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A Convertible Preferred StockF2 | — | holding | — | — | — | — | — | Common Stock | 1,358 | 7,000 | D |
| Non-Qualified Stock Option (Right to Buy)F3 | $2.05 | holding | — | — | — | — | Jun 18, 2021 | Common Stock | 20,000 | 20,000 | I |
Explanation of responses
- F1This transaction was executed in multiple trades at prices ranging from $3.84 to $3.89. The price set forth above reflects the weighted-average price per share. Mr. Moschner hereby undertakes to provide, upon request, to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transactions were effected.
- F2As of April 25, 2016, each share of series A convertible preferred stock was convertible into 0.1940 of a share of common stock at the option of the holder and is subject to further adjustment as provided in the Articles of Incorporation. The shares do not have an expiration date.
- F3The options vested or vest as follows: 6,667 on 6/18/15; 6,667 on 6/18/16; and 6,666 on 6/18/17.