Amended Statement of Beneficial Ownership (3/a)
11 March 2022 - 9:54AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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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Gutteridge Mike |
2. Date of Event Requiring Statement (MM/DD/YYYY)
2/15/2022
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3. Issuer Name and Ticker or Trading Symbol
Apollo Endosurgery, Inc. [APEN]
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(Last)
(First)
(Middle)
1120 SOUTH CAPITAL OF TEXAS HIGHWAY, BUILDING ONE, SUITE 300 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) VP, Int'l Sales and Marketing / |
(Street)
AUSTIN, TX 78746
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY) 3/1/2022
| 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 Beneficially Owned
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1.Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 22838 | D | |
Common Stock | 21403 (1) | D | |
Common Stock | 19796 (2) | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Stock Option (Right to Buy) | (3) | 5/25/2027 | Common Stock | 14000.0 | $6.5 | D | |
Stock Option (Right to Buy) | (4) | 12/7/2027 | Common Stock | 25500.0 | $4.37 | D | |
Stock Option (Right to Buy) | (4) | 5/7/2029 | Common Stock | 22655.0 | $3.49 | D | |
Stock Option (Right to Buy) | (5) | 5/7/2030 | Common Stock | 22171.0 | $2.08 | D | |
Stock Option (Right to Buy) | (4) | 3/10/2031 | Common Stock | 14846.0 | $5.95 | D | |
Explanation of Responses: |
(1) | Represents grants of Restricted Stock Units (the "RSU Awards") payable solely in common stock of the Issuer. The shares subject to the RSU Awards shall vest over a four-year period at the rate of 25% per year. |
(2) | Represents grants of "RSU Awards" payable solely in common stock of the Issuer. The shares subject to the RSU Awards shall vest over a three-year period at the rate of 33% per year. |
(3) | The shares underlying the performance based option vested 25% on 1/2/2018 and the remainder will vest in equal monthly installments over the following three years. |
(4) | The shares underlying the option shall vest as to 25% on the first anniversary of the grant date and the remainder will vest in equal monthly installments over the following three years. |
(5) | The shares underlying the option shall vest as to 33% on the first anniversary of the grant date and the remainder will vest in equal monthly installments over the following two years. |
Remarks: Corrected Table I breakout and footnotes, and corrected Table II footnotes. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Gutteridge Mike 1120 SOUTH CAPITAL OF TEXAS HIGHWAY BUILDING ONE, SUITE 300 AUSTIN, TX 78746 |
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| VP, Int'l Sales and Marketing |
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Signatures
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/s/ Brian Szymczak - Attorney-in-Fact | | 3/10/2022 |
**Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* | If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
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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