Statement of Changes in Beneficial Ownership (4)
December 03 2021 - 6:17PM
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
*
Bauerlein Alison |
2. Issuer Name and Ticker or Trading Symbol
Inogen Inc
[
INGN
]
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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) EVP, Finance, & CFO |
(Last)
(First)
(Middle)
C/O INOGEN, INC., 301 COROMAR DRIVE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/1/2021 |
(Street)
GOLETA, CA 93117
(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 | 12/1/2021 | | M | | 546 | A | $0.00 | 34392 (1) | D | |
Common Stock | 12/1/2021 | | F | | 490 (2) | D | $29.66 | 33902 (1) | D | |
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 |
Restricted Stock Unit | (3) | 12/1/2021 | | M | | | 546 | (4) | (4) | Common Stock | 546 | $0.00 | 4915 | D | |
Explanation of Responses: |
(1) | Shares beneficially owned are 30,155 shares more than the previously filed Form 4s due to an error reporting the shares owned on December 15, 2020. An amendment to the original Form 4 has been filed to correct the error. |
(2) | The reported shares were withheld to cover the Reporting Person's tax withholding liability in connection with a portion of a time-based restricted stock award that vested on December 1, 2021. |
(3) | Each restricted stock unit represents a contingent right to receive one share of Inogen common stock. |
(4) | Subject to the reporting person's continued service, 25% of the restricted stock units shall vest on March 1, 2021, and 1/16th of the restricted stock units shall vest every three months thereafter on the 1st day of the month, subject to the reporting person continuing to be a service provider through each such vesting date. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Bauerlein Alison C/O INOGEN, INC. 301 COROMAR DRIVE GOLETA, CA 93117 |
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| EVP, Finance, & CFO |
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Signatures
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/s/ Alison Bauerlein | | 12/3/2021 |
**Signature of Reporting Person | Date |
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