Statement of Changes in Beneficial Ownership (4)
January 06 2020 - 4:06PM
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
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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
*
Dyer Jeffrey Hansen |
2. Issuer Name and Ticker or Trading Symbol
POLARITYTE, INC.
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PTE
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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)
4041-T HADLEY ROAD |
3. Date of Earliest Transaction
(MM/DD/YYYY)
1/2/2020 |
(Street)
SOUTH PLAINFIELD, NJ 07080
(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 | 1/2/2020 | | A | | 10769 | A | (1) | 502667 | D | |
Common Stock | | | | | | | | 700 (2) | I | Cust. for daughter,UGMA |
Common Stock | | | | | | | | 1200 (2) | I | Cust. for son,UGMA |
Common Stock | | | | | | | | 1740 (2) | I | Cust. for daughter,UTMA |
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) | 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 |
Stock option (Right to Buy) | $2.60 | 1/2/2020 | | A | | 24984 | | 2/1/2020 | 1/31/2030 | Common Stock | 24984 | $2.08 (3) | 24984 | D | |
Explanation of Responses: |
(1) | The shares were issued as restricted share units pursuant to the 2019 Equity Incentive Plan for annual director fees totaling $28,000 or $2.60 per share. The shares vest in 12 equal monthly installments beginning February 1, 2020. |
(2) | The reporting person disclaims beneficial ownership of these shares, and this report shall not be deemed an admission that the reporting is the beneficial owner of these shares for purposes of section 16 or for any other purpose. |
(3) | This option was issued to the reporting person pursuant to the 2019 Equity Incentive Plan for annual director fees in the amount of $52,000. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Dyer Jeffrey Hansen 4041-T HADLEY ROAD SOUTH PLAINFIELD, NJ 07080 | X |
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Signatures
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/s/ Jeffrey H. Dyer | | 1/6/2020 |
**Signature of Reporting Person | Date |
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