Statement of Changes in Beneficial Ownership (4)
November 26 2021 - 6:11PM
Edgar (US Regulatory)
FORM 4
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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
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BLOCH KATHLEEN P. |
2. Issuer Name and Ticker or Trading Symbol
Cytosorbents Corp
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CTSO
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chief Financial Officer |
(Last)
(First)
(Middle)
C/O CYTOSORBENTS CORPORATION, 7 DEER PARK DRIVE, SUITE K |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/23/2021 |
(Street)
MONMOUTH JUNCTION, NJ 08852
(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 | 11/23/2021 | | P | | 4000 | A | $4.98 | 25000 | I | See Footnote (1) |
Common Stock | | | | | | | | 361433 | D (2)(3)(4) | |
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 |
Explanation of Responses: |
(1) | Includes (i) 10,000 shares held by the Reporting Person's husband in a 401(k) account and (ii) 15,000 shares held by the Reporting Person's husband in an IRA account (including the 4,000 shares reported on this Form 4). The Reporting Person may be deemed the beneficial owner of such shares. |
(2) | Includes the following RSUs that will be settled into common stock, par value $0.001 per share (the "Common Stock") upon a "Change In Control" of CytoSorbents Corporation (the "Company"), as defined in the Amended and Restated CytoSorbents Corporation 2014 Long-Term Incentive Plan: (a) 8,800 RSUs granted on March 15, 2018, (b) 15,700 RSUs granted on February 24, 2017, (c) 47,000 RSUs granted on June 7, 2016 and (d) 110,000 RSUs granted on April 8, 2015. |
(3) | Includes the following RSUs (which vest as to one-third of the award on each of the date of grant, the first anniversary of the date of grant, and the second anniversary of the date of grant, subject to the Reporting Person's continued service as of the applicable vesting date), and will be settled into common stock of the Company upon vesting: (a) 32,967 RSUs granted on April 12, 2021 and unvested as of the date hereof, and (b) 14,334 RSUs granted on February 28, 2020 and unvested as of the date hereof. |
(4) | Includes 132,632 shares of Common Stock owned by the Reporting Person. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
BLOCH KATHLEEN P. C/O CYTOSORBENTS CORPORATION 7 DEER PARK DRIVE, SUITE K MONMOUTH JUNCTION, NJ 08852 |
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| Chief Financial Officer |
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Signatures
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/s/ Kathleen P. Bloch | | 11/26/2021 |
**Signature of Reporting Person | Date |
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