Statement of Changes in Beneficial Ownership (4)
March 30 2023 - 09:00AM
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).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
|
OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
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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 * MICHEL GERARD J |
2. Issuer Name and Ticker or Trading
Symbol DELCATH SYSTEMS, INC. [ DCTH ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Chief Executive Officer |
(Last)
(First)
(Middle)
C/O DELCATH SYSTEMS, INC.,, 1633 BROADWAY, SUITE
22C |
3. Date of Earliest Transaction (MM/DD/YYYY)
3/29/2023
|
(Street)
NEW YORK, NY 10019 |
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 |
(City)
(State)
(Zip)
|
Rule 10b5-1(c) Transaction Indication
☐ Check this box to indicate
that a transaction was made pursuant to a contract, instruction or
written plan that is intended to satisfy the affirmative defense
conditions of Rule 10b5-1(c). See Instruction 10. |
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 |
3/29/2023 |
|
P |
|
19646 |
A |
$4.84 (1) |
197235 |
D |
|
Table II - Derivative Securities 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 |
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 |
Tranche A Warrants to Purchase Common
Stock |
$4.50 |
3/29/2023 |
|
P |
|
31110 |
|
3/29/2023 (2) |
(3) |
Common Stock |
31110 |
$0.125 (1) |
31110 |
D |
|
Tranche B Warrants to Purchase Common
Stock |
$6.00 |
3/29/2023 |
|
P |
|
16666 |
|
3/29/2023 (2) |
(4) |
Common Stock |
16666 |
$0.125 (1) |
16666 |
D |
|
Explanation of
Responses: |
(1) |
The common stock and Tranche
A and Tranche B Warrants were acquired in the issuer's private
placement of common stock and warrants, issued as part of a unit.
The per unit purchase price was $5.09, including a purchase price
of $4.84 per share of common stock and $0.125 for each of the
Tranche A and Tranche B Warrants. Each unit consisted of one share
of common stock and an accompanying common stock warrant valued at
140% of the aggregate purchase price (the Tranche A Warrant) and an
accompanying common stock warrant valued at 100% of the aggregate
purchase price (the Tranche B Warrant). |
(2) |
The Tranche A Warrants and
Tranche B Warrants are immediately exercisable. |
(3) |
The Tranche A Warrants
expire the earlier of (i) twenty-one (21) days following the date
of the Issuer's public announcement of its receipt of written
approval from the U.S. Food and Drug Administration of its New Drug
Application for HEPZATO (the "FDA Approval") and (ii) March 31,
2026. |
(4) |
The Tranche B Warrants
expire the earlier of (i) twenty-one (21) days following the date
of the Issuer's public announcement of record at least $10,000,000
in quarterly U.S. revenue from the commercialization of HEPZATO and
(ii) March 31, 2026, provided, however, if the FDA Approval occurs
on or before February 15, 2024 and the Tranche A Warrants have not
been exercised in full on or before March 7, 2024, then the Tranche
B Warrants shall automatically expire on March 8, 2024. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
MICHEL GERARD J
C/O DELCATH SYSTEMS, INC.,
1633 BROADWAY, SUITE 22C
NEW YORK, NY 10019 |
X |
|
Chief Executive Officer |
|
Signatures
|
/s/ Gerard Michel |
|
3/30/2023 |
**Signature of Reporting
Person |
Date |
Reminder: Report on a separate line for each class
of securities beneficially owned directly or
indirectly. |
* |
If the form is filed by more than one
reporting person, see Instruction 4(b)(v). |
** |
Intentional misstatements or omissions
of facts constitute Federal Criminal Violations. See 18
U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: |
File three copies of this Form, one of
which must be manually signed. If space is insufficient, see
Instruction 6 for procedure. |
Persons who respond to the collection of information
contained in this form are not required to respond unless the form
displays a currently valid OMB control number. |
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