Initial Statement of Beneficial Ownership (3)
April 19 2016 - 1:53PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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
*
Harris Taylor C.
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2. Date of Event Requiring Statement (MM/DD/YYYY)
4/18/2016
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3. Issuer Name
and
Ticker or Trading Symbol
Zeltiq Aesthetics Inc [ZLTQ]
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(Last)
(First)
(Middle)
C/O ZELTIQ AESTHETICS, INC., 4698 WILLOW ROAD, SUITE 100
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
___
X
___ Officer (give title below)
_____ Other (specify below)
SVP & Chief Financial Officer /
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(Street)
PLEASANTON, CA 94588
(City)
(State)
(Zip)
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5. 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 Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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55865
(1)
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D
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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. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Employee Stock Option (right to buy)
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(2)
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2/1/2026
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Common Stock
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106411
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$20.81
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D
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Explanation of Responses:
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(
1)
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The restricted stock units (the "RSUs") vest in four equal annual installments beginning on the first anniversary of March 1, 2016. Vested shares will be delivered to the Reporting Person upon vesting of the RSUs.
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(
2)
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25% of the total number of shares subject to the option vests on the first anniversary of the vesting commencement date of March 1, 2016, and the remainder vest in equal monthly installments over a 36-month period thereafter, subject to the Reporting Person's continued service to the Issuer.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Harris Taylor C.
C/O ZELTIQ AESTHETICS, INC.
4698 WILLOW ROAD, SUITE 100
PLEASANTON, CA 94588
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SVP & Chief Financial Officer
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Signatures
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/s/ Sergio Garcia, Attorney-in-Fact
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4/19/2016
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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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