Statement of Changes in Beneficial Ownership (4)
May 20 2021 - 4:59PM
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
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BOCHNOWSKI JAMES J |
2. Issuer Name and Ticker or Trading Symbol
Jaguar Health, Inc.
[
JAGX
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O JAGUAR HEALTH, INC., 200 PINE STREET, SUITE 400 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
5/18/2021 |
(Street)
SAN FRANCISCO, CA 94104
(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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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 |
Stock option (right to buy) (1) | $1.24 | 5/18/2021 (2) | | A | | 78750 | | (3) | 5/18/2031 | Common Stock | 78750 | $0 | 78750 | D | |
Restricted stock units (1) | (4) | 5/18/2021 (2) | | A | | 39400 | | (5) | (5) | Common Stock | 39400 | $0 | 39400 | D | |
Explanation of Responses: |
(1) | Granted pursuant to the issuer's 2014 Stock Incentive Plan. |
(2) | The option and restricted stock unit grants were approved by the issuer's board of directors on May 18, 2021. |
(3) | The options will vest in full on May 18, 2022, the first anniversary of the grant date, so long as the director continues to serve on the board of directors of the issuer. |
(4) | Each restricted stock unit represents a contingent right to receive one share of the issuer's common stock. |
(5) | The restricted stock units vest in full on May 18, 2022, the first anniversary of the grant date. Vested shares will be delivered to the reporting person on the vesting date provided in the grant notice. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
BOCHNOWSKI JAMES J C/O JAGUAR HEALTH, INC. 200 PINE STREET, SUITE 400 SAN FRANCISCO, CA 94104 | X |
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Signatures
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/s/ James J. Bochnowski | | 5/19/2021 |
**Signature of Reporting Person | Date |
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