Statement of Changes in Beneficial Ownership (4)
December 02 2020 - 5:01PM
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
*
Burnell Thomas W. |
2. Issuer Name and Ticker or Trading Symbol
INTERPACE BIOSCIENCES, INC.
[
IDXG
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) President and CEO |
(Last)
(First)
(Middle)
C/O INTERPACE BIOSCIENCES, INC., 300 INTERPACE PARKWAY |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/1/2020 |
(Street)
PARSIPPANY,, NJ 07054
(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 | 12/1/2020 | | A | | 100000 (1) | A | $0 | 225000 | D | |
Common Stock | 12/1/2020 | | A | | 125000 (2) | A | $0 | 225000 | 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 |
Explanation of Responses: |
(1) | These restricted stock units vest annually in equal installments on each of the first three anniversaries of their date of grant, subject to the reporting person's continued service with the Issuer through the applicable vesting date. Each restricted stock unit represents a right to receive one share of the Issuer's common stock upon vesting. |
(2) | These restricted stock units vest on the day following a 30 calendar day period in which, for each trading day of such period, a share of the Issuer's common stock has a closing per share price of at least $11.34. Each restricted stock unit represents a right to receive one share of the Issuer's common stock upon vesting. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Burnell Thomas W. C/O INTERPACE BIOSCIENCES, INC. 300 INTERPACE PARKWAY PARSIPPANY,, NJ 07054 | X |
| President and CEO |
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Signatures
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/s/ Thomas W. Burnell | | 12/2/2020 |
**Signature of Reporting Person | Date |
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