Statement of Changes in Beneficial Ownership (4)
December 18 2020 - 09:24AM
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).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
|
OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
|
Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
|
|
1. Name
and Address of Reporting Person * Acheson David |
2. Issuer Name and Ticker or Trading
Symbol CHEMBIO DIAGNOSTICS, INC. [ CEMI ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
_____ Officer (give title
below) _____ Other
(specify below)
|
(Last)
(First)
(Middle)
C/O CHEMBIO DIAGNOSTICS, INC., 555 WIRELESS
BOULEVARD |
3. Date of Earliest Transaction (MM/DD/YYYY)
12/17/2020
|
(Street)
HAUPPAUGE, NY 11788
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
6. Individual or Joint/Group Filing
(Check Applicable Line) _X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. 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 |
7. Title and Amount of Securities Underlying
Derivative Security
(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) |
Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Restricted stock units |
(1) |
12/17/2020 |
|
A |
|
14678 |
|
(2) |
(2) |
Common stock |
14678 |
$0 |
14678 |
D |
|
Nonqualified stock options |
$5.45 |
12/17/2020 |
|
A |
|
23781 |
|
(3) |
12/16/2027 |
Common stock |
23781 |
$0 |
23781 |
D |
|
Explanation of
Responses: |
(1) |
Each restricted stock unit
represents a contingent right to receive one share of Common
Stock. |
(2) |
The restricted stock units
are scheduled to vest in three equal installments on December 17,
2021, 2022 and 2023, provided they shall vest in full immediately
prior to a Change in Control (as defined in the 2019 Omnibus
Incentive Plan of the issuer). |
(3) |
The nonqualified stock
options are scheduled to vest and become exercisable in full
immediately prior to the earlier to occur of (i) the 2022 annual
meeting of stockholders of the issuer and (ii) a Change in
Control. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Acheson David
C/O CHEMBIO DIAGNOSTICS, INC.
555 WIRELESS BOULEVARD
HAUPPAUGE, NY 11788 |
X |
|
|
|
Signatures
|
/s/ Mark L. Johnson, Attorney-in-Fact for David
Acheson |
|
12/18/2020 |
**Signature of Reporting
Person |
Date |