Statement of Changes in Beneficial Ownership (4)
December 13 2021 - 09:06AM
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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APPROVAL
OMB Number: 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 * Chan Phillip
P. |
2. Issuer Name and Ticker or Trading
Symbol Cytosorbents Corp [ CTSO ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Chief Executive Officer |
(Last)
(First)
(Middle)
C/O CYTOSORBENTS CORPORATION, 7 DEER PARK DRIVE, SUITE
K |
3. Date of Earliest Transaction (MM/DD/YYYY)
12/10/2021
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(Street)
MONMOUTH JUNCTION, NJ 08852
(City)
(State)
(Zip)
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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) |
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
12/10/2021 |
|
P |
|
5000 |
A |
$5.25 |
753443 (1)(2) |
D |
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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 |
Explanation of
Responses: |
(1) |
Includes: (i) the following
restricted stock units ("RSUs") that will be settled into shares of
the Issuer's common stock upon vesting upon a "Change In Control"
of the Issuer as defined in the Amended and Restated CytoSorbents
Corporation 2014 Long-Term Incentive Plan (the "Plan"): (a) 10,300
RSUs granted on March 15, 2018, (b) 18,700 RSUs granted on February
24, 2017, (c) 57,000 RSUs granted on June 7, 2016 and (d) 130,000
RSUs granted on April 8, 2015; (ii) 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 settle into
shares of the Issuer's common stock upon vesting: (a) 48,000 RSUs
granted on April 12, 2021 and unvested on the date hereof, and (b)
20,000 RSUs granted on February 28, 2020 and unvested on the date
hereof, and |
(2) |
(iii) 469,443 shares of the
Issuer's common stock owned by the reporting person, inclusive of
the 5,000 shares of the Issuer's common stock reported on this Form
4. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Chan Phillip P.
C/O CYTOSORBENTS CORPORATION
7 DEER PARK DRIVE, SUITE K
MONMOUTH JUNCTION, NJ 08852 |
|
|
Chief Executive Officer |
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Signatures
|
/s/ Kathleen P. Bloch attorney-in-fact for
Phillip P. Chan |
|
12/13/2021 |
**Signature
of Reporting Person |
Date |
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