Annual Statement of Changes in Beneficial Ownership (5)
January 13 2020 - 5:27PM
Edgar (US Regulatory)
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
[ ]
Form 3 Holdings Reported
[X]
Form 4 Transactions Reported
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0362
Estimated average burden hours per response...
1.0
|
|
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
*
Dyer Jeffrey Hansen | 2. Issuer Name and Ticker or Trading SymbolPOLARITYTE, INC. [PTE] |
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)
4041-T HADLEY ROAD | 3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY) 12/31/2019 |
(Street)
SOUTH PLAINFIELD, NJ 07080
(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) |
Amount | (A) or (D) | Price |
Common Stock | 11/1/2019 | | M4 | 4020 | A | (1) | 54286 | 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 Acquired, Disposed of, or 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 (MM/DD/YYYY) | 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 at End of Issuer's Fiscal Year (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Restricted Stock Units | | 11/1/2019 | | M | | 4020 | (3) | (3) | Common Stock | 4020 | $0 | 0 | D | |
Explanation of Responses: |
(1) | Restricted stock units convert into common stock on a one-for-one basis. |
(2) | The reporting person disclaims beneficial ownership of these shares, and this report shall not be deemed an admission that the reporting
person is the beneficial owner of these shares for purposes of section 16 or for any other purposes. |
(3) | On November 1, 2018, the reporting person was granted 4,020 rested stock units that vested November 1, 2019. |
Reporting Owners
|
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Dyer Jeffrey Hansen 4041-T HADLEY ROAD SOUTH PLAINFIELD, NJ 07080 | X |
|
|
|
Signatures
|
/s/ Jeffrey H. Dyer | | 1/13/2020 |
**Signature of Reporting Person | Date |
PolarityTE (NASDAQ:PTE)
Historical Stock Chart
From Aug 2024 to Sep 2024
PolarityTE (NASDAQ:PTE)
Historical Stock Chart
From Sep 2023 to Sep 2024