Statement of Changes in Beneficial Ownership (4)
December 10 2021 - 04:49PM
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
|
|
1. Name
and Address of Reporting Person * SAXENA PARAG |
2. Issuer Name and Ticker or Trading
Symbol REVIVA PHARMACEUTICALS HOLDINGS, INC. [ RVPH
] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director __X__
10% Owner
_____ Officer (give title
below) _____ Other
(specify below)
|
(Last)
(First)
(Middle)
C/O VEDANTA MANAGEMENT LP, 250 WEST 55TH STREET, SUITE
13D |
3. Date of Earliest Transaction (MM/DD/YYYY)
12/8/2021
|
(Street)
NEW YORK, NY 10019
(City)
(State)
(Zip)
|
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 |
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 |
Stock Option (right to buy) |
$3.78 |
12/8/2021 |
|
A |
|
5300 |
|
(1) |
12/7/2031 |
Common Stock, par value $0.0001 per
share |
5300 |
$0 |
5300 |
D |
|
Explanation of
Responses: |
(1) |
The option award was made in
accordance with the terms of the Issuer's 2020 Equity Incentive
Plan (the "2020 Plan"). The Option will vest at the rate of one
hundred percent (100%) of the shares subject thereto upon the one
year anniversary of the date of grant, provided that Awardee
remains a director of the Company through such vesting date. The
exercise price is based on the closing price for the shares of the
Common Stock on the date of grant in accordance with the terms of
the 2020 Plan. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
SAXENA PARAG
C/O VEDANTA MANAGEMENT LP
250 WEST 55TH STREET, SUITE 13D
NEW YORK, NY 10019 |
X |
X |
|
|
Signatures
|
/s/ Parag Saxena |
|
12/10/2021 |
**Signature of Reporting
Person |
Date |
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