Statement of Changes in Beneficial Ownership (4)
March 05 2020 - 5:18PM
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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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
*
Evans Daron |
2. Issuer Name and Ticker or Trading Symbol
NEPHROS INC
[
NEPH
]
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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 NEPHROS, INC., 380 LACKAWANNA PLACE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/5/2020 |
(Street)
SOUTH ORANGE, NJ 07079
(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 | 3/5/2020 | | P | | 2500 | A | $8.4436 (1) | 131715 | D | |
Common Stock | | | | | | | | 8185 | I | By UTMA #1 |
Common Stock | | | | | | | | 7907 | I | By UTMA #2 |
Common Stock | | | | | | | | 888 | I | By UTMA #3 |
Common Stock | | | | | | | | 888 | I | By UTMA #4 |
Common Stock | | | | | | | | 6111 | I | By PoC Capital, LLC (2) |
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) | $4.14 | | | | | | | (3) | 3/26/2024 | Common Stock | 8374 | | 8374 | D | |
Stock Option (Right to Buy) | $5.40 | | | | | | | (4) | 4/15/2025 | Common Stock | 242690 | | 242690 | D | |
Stock Option (Right to Buy) | $4.50 | | | | | | | (5) | 12/20/2027 | Common Stock | 93014 | | 93014 | D | |
Stock Option (Right to Buy) | $8.57 | | | | | | | (6) | 12/16/2029 | Common Stock | 20000 | | 20000 | D | |
Common Stock Warrants (Right to Buy) | $2.70 | | | | | | | 6/3/2016 | 6/3/2021 | Common Stock | 1112 | | 1112 | I | By UTMA #1 |
Common Stock Warrants (Right to Buy) | $2.70 | | | | | | | 6/3/2016 | 6/3/2021 | Common Stock | 1112 | | 1112 | I | By UTMA #2 |
Common Stock Warrants (Right to Buy) | $2.70 | | | | | | | 3/17/2017 | 3/17/2022 | Common Stock | 4630 | | 4630 | I | By UTMA #1 |
Common Stock Warrants (Right to Buy) | $2.70 | | | | | | | 3/17/2017 | 3/17/2022 | Common Stock | 4630 | | 4630 | I | By UTMA #2 |
Explanation of Responses: |
(1) | The reported price in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $8.40 to $8.4567. The reporting person undertakes to provide Nephros, Inc., any security holder of Nephros, Inc. or the staff of the Securities and Exchange Commission upon request, full information regarding the number of shares purchased at each separate price within the range set forth in this footnote. |
(2) | The Reporting Person is a managing director of the LLC that owns the reported securities. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
(3) | Fully exercisable. |
(4) | On 4/15/15, the Reporting Person was granted an option to purchase 242,690 shares of common stock of the Company. Options to purchase 84,941 shares vest quarterly in 16 equal amounts commencing on 6/30/15; options to purchase 36,404 shares vested on 8/9/19; and options to purchase 121,345 shares vested upon achievement of previously disclosed performance measures. |
(5) | On 12/20/17, the Reporting Person was granted an option to purchase 93,014 shares of common stock of the Company. Options to purchase 23,253 shares vested on 12/20/18 and options to purchase 69,761 shares vest quarterly in 12 equal amounts commencing on 3/20/19. |
(6) | On 12/16/19, the Reporting Person was granted an option to purchase 20,000 shares of common stock of the Company. Options to purchase 5,000 shares vest on 12/16/20 and options to purchase 15,000 shares vest quarterly in 12 equal amounts commencing on 3/16/21. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Evans Daron C/O NEPHROS, INC. 380 LACKAWANNA PLACE SOUTH ORANGE, NJ 07079 | X |
| President and CEO |
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Signatures
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/s/ Daron Evans | | 3/5/2020 |
**Signature of Reporting Person | Date |
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