Statement of Changes in Beneficial Ownership (4)
June 16 2021 - 4:31PM
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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3235-0287
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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
*
Funtleyder Leslie D. |
2. Issuer Name and Ticker or Trading Symbol
REVIVA PHARMACEUTICALS HOLDINGS, INC.
[
RVPH
]
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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)
C/O REVIVA PHARMACEUTICALS HOLDINGS, INC, 19925 STEVENS CREEK BLVD, SUITE 100 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/15/2021 |
(Street)
CUPERTINO, CA 95014
(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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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) | $4.73 | 6/15/2021 | | A | | 4000 | | (1) | 6/14/2031 | Common Stock, par value $0.0001 per share | 4000 | $0 | 4000 | D | |
Explanation of Responses: |
(1) | The option award was made in accordance with the terms of the Issuer's 2020 Equity Incentive Plan (the "2020 Plan"). The Option will vest at the rate of thirty-three percent (33%) of the shares subject thereto upon the one year anniversary of December 14, 2020, and as to an additional thirty-three percent (33%) of the shares subject to the Option on each successive one year anniversary thereafter, provided that Awardee remains a director of the Company through each such vesting date. The exercise price is based on the closing price for the shares of the Common Stock on the date of grant in accordance with the terms of the 2020 Plan. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Funtleyder Leslie D. C/O REVIVA PHARMACEUTICALS HOLDINGS, INC 19925 STEVENS CREEK BLVD, SUITE 100 CUPERTINO, CA 95014 | X |
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Signatures
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/s/ Narayan Prabhu, attorney-in-fact for Leslie Funtleyder | | 6/16/2021 |
**Signature of Reporting Person | Date |
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