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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Common Stock Warrants | $ 4.25 | 05/18/2022 | J(1) | 23,530 | 05/18/2022 | 05/18/2027 | Common Stock | 23,530 | $ 0.125 | 23,530 | D | ||||
Stock Options | $ 10.065 (2) | 12/07/2021 | A | 25,000 (2) | (3) | 12/07/2031 | Common Stock | 25,000 | (4) | 25,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Shoemaker Sandy L 6400 SOUTH FIDDLERS GREEN CIRCLE SUITE 525 GREENWOOD VILLAGE, CO 80111 |
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/s/ Sandy Shoemaker | 06/15/2022 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(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). |
(1) | Mrs. Shoemaker acquired the 11,765 Units for $50,000 in the Issuer's recent $10 million firm underwritten public offering, with each Unit consisting of one share of Issuer's common stock and two warrants, each to purchase one share of the Issuer's common stock at $4.25. The price per Unit was $4.25, with $4.00 of the Unit price attributed to the share of common stock and $0.125 of the Unit price attributed to each warrant. |
(2) | Adjusted for the 1-for-3 reverse stock split of the Issuer's common stock effected April 28, 2022. |
(3) | The stock options vest as to 4,167 shares each quarter for four quarters after the grant date and then as to 2,084 shares each quarter for an additional four quarters. |
(4) | Issued to Mrs. Shoemaker for agreeing to serve on the Issuer's Board of Directors and for agreeing to be the chairperson of the Audit Committee of the Issuer's Board of Directors. |