Statement of Changes in Beneficial Ownership (4)
02 October 2018 - 6:03AM
Edgar (US Regulatory)
FORM 4
[ ]
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
Estimated average burden
hours per response...
0.5
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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
*
Lefkowitz Steven W
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2. Issuer Name
and
Ticker or Trading Symbol
CorMedix Inc.
[
CRMD
]
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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)
C/O CORMEDIX INC., 400 CONNELL DRIVE, SUITE 5000
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3. Date of Earliest Transaction
(MM/DD/YYYY)
10/1/2018
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(Street)
BERKELEY HEIGHTS, NJ 07922
(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, $0.001 par value per share
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195379
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D
(1)
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Common Stock, $0.001 par value per share
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115757
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I
(2)
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Wade Capital Corporation Money Purchase Plan
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Common Stock, $0.001 par value per share
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10000
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I
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Reporting Person's Wife
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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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Restricted Stock Units
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$0
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10/1/2018
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10/1/2018
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A
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10000
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(3)
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(3)
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Common Stock
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10000
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$0
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10000
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D
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Stock Option (Right to Buy Common Stock)
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$0.57
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(4)
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2/16/2028
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Common Stock
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40000
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40000
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D
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Restricted Stock Units
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(5)
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(5)
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(5)
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Common Stock
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10000
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10000
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D
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Restricted Stock Units
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(5)
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(5)
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(5)
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Common Stock
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6000
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6000
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D
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Stock Option (Right to Buy Common Stock)
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$0.45
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(6)
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6/25/2027
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Common Stock
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75000
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75000
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D
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Warrant (Right to Purchase Common Stock)
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$0.90
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1/8/2015
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1/8/2020
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Common Stock
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22500
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22500
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D
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Warrant (Right to Purchase Common Stock)
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$0.90
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1/8/2015
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1/8/2020
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Common Stock
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15000
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15000
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D
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Explanation of Responses:
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(1)
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Includes 24,963 shares held by the reporting person for the benefit of his minor son.
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(2)
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The reporting person beneficially owns these securities through Wade Capital Corporation Money Purchase Plan (an entity for which he has voting and investment control).
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(3)
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These restricted stock units were granted on 10/01/2018 for service on the Company's Strategic Finance Committee. Each restricted stock unit represents the right to receive one share of CorMedix Inc. common stock. The restricted stock units vest monthly and will vest in full on the first anniversary of the date of grant, subject to continued service on the board.
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(4)
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These options vest in full on the first anniversary of the date of grant, subject to continued service on the board.
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(5)
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These Restricted Stock Units were granted on 2/16/2018. Each restricted stock unit represents the right to receive one share of CorMedix Inc. common stock. The restricted stock units vest in full on the first anniversary of the date of grant, subject to continued service on the board.
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(6)
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These options were granted on 6/25/2017. These options vest 1/3 on the date of grant, 1/3 on the first anniversary of the date of grant and 1/3 on the second anniversary of the date of grant.
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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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Lefkowitz Steven W
C/O CORMEDIX INC.
400 CONNELL DRIVE, SUITE 5000
BERKELEY HEIGHTS, NJ 07922
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X
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Signatures
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/s/ Alexander M. Donaldson, by power of attorney
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10/1/2018
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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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