Statement of Changes in Beneficial Ownership (4)
31 Oktober 2019 - 9:52PM
Edgar (US Regulatory)
FORM 4
[X]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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GOLD JEFFREY |
2. Issuer Name and Ticker or Trading Symbol
Corindus Vascular Robotics, Inc.
[
CVRS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
309 WAVERLEY OAKS RD., SUITE 105 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
10/29/2019
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(Street)
WALTHAM, MA 02452
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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10/29/2019
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D(1)
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115149 (2)
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D
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$4.28 (3)
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0
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D
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code (Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)
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8. Price of Derivative Security (Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Non-qualified stock option (right to buy)
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$0.5499
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10/29/2019
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D (1)
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50004
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(4)
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2/10/2021
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Common Stock
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50004
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$3.73 (5)
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0
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D
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Non-qualified stock option (right to buy)
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$0.5499
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10/29/2019
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D (1)
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25002
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(4)
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2/10/2021
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Common Stock
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25002
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$3.73 (5)
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0
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D
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Non-qualified stock option (right to buy)
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$0.5499
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10/29/2019
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D (1)
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57504
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(4)
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2/10/2022
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Common Stock
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57504
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$3.73 (5)
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0
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D
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Non-qualified stock option (right to buy)
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$0.5499
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10/29/2019
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D (1)
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25002
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(4)
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2/10/2022
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Common Stock
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25002
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$3.73 (5)
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0
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D
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Non-qualified stock option (right to buy)
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$0.5499
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10/29/2019
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D (1)
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25002
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(4)
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2/10/2022
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Common Stock
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25002
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$3.73 (5)
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0
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D
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Non-qualified stock option (right to buy)
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$4.25
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10/29/2019
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D (1)
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68493
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(4)
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5/27/2025
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Common Stock
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68493
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$0.03 (5)
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0
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D
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Non-qualified stock option (right to buy)
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$1.46
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10/29/2019
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D (1)
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35000
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(4)
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6/22/2026
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Common Stock
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35000
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$2.82 (5)
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0
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D
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Non-qualified stock option (right to buy)
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$1.1
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10/29/2019
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D (1)
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27272
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(6)
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9/26/2026
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Common Stock
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27272
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$3.18 (5)
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0
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D
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Non-qualified stock option (right to buy)
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$1.68
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10/29/2019
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D (1)
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17857
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(6)
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6/21/2027
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Common Stock
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17857
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$2.6 (5)
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0
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D
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Explanation of Responses:
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(1)
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On October 29, 2019, Siemens Medical Solutions USA, Inc., a Delaware corporation ("Parent"), acquired the Issuer pursuant to that certain Agreement and Plan of Merger entered into by and among the Issuer, Parent and Corpus Merger Inc., a Delaware corporation and wholly-owned subsidiary of Parent ("Merger Sub"), dated as of August 7, 2019 (the "Merger Agreement"). In accordance with the Merger Agreement, Merger Sub merged with and into the Issuer, with the Issuer surviving such merger as a wholly-owned subsidiary of Parent (the "Merger").
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(2)
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These shares represent 94,412 shares of the Issuer's common stock and 20,737 restricted stock units ("RSUs").
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(3)
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At the effective time of the Merger (the "Effective Time"), which occurred on October 29, 2019, (i) each outstanding share of the Issuer's common stock (other than certain excluded shares) automatically converted into the right to receive $4.28 in cash, without interest and less any applicable withholding taxes, and (ii) each outstanding RSU converted into the right to receive a cash payment equal to the product of (a) $4.28 and (b) the number of shares of the Issuer's common stock underlying the RSU as of the Effective Time, without interest and net of any applicable withholding taxes.
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(4)
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This option provided for vesting in two equal installments at the end of each anniversary of the date of grant.
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(5)
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At the Effective Time, each outstanding and unexercised option to purchase shares of the Issuer's common stock automatically converted into the right to receive a cash payment equal to the product of (i) the excess, if any, of $4.28 over the per share exercise price of such option, and (ii) the number of shares of the Issuer's common stock subject to such option as of the Effective Time, without interest and net of any applicable withholding taxes.
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(6)
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This option provided for vesting over a period of three years with 33.33% vesting on the first anniversary of issuance and 8.334% vesting at the end of each calendar quarter thereafter.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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GOLD JEFFREY 309 WAVERLEY OAKS RD., SUITE 105 WALTHAM, MA 02452
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X
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Signatures
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/s/ Jeffrey G. Gold
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10/31/2019
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**Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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