Initial Statement of Beneficial Ownership (3)
March 06 2015 - 2:09PM
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
Estimated average burden
hours per response...
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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
*
Hammond Kurt R.
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2. Date of Event Requiring Statement (MM/DD/YYYY)
2/25/2015
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3. Issuer Name
and
Ticker or Trading Symbol
MERGE HEALTHCARE INC [MRGE]
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(Last)
(First)
(Middle)
350 NORTH ORLEANS STREET, FIRST FLOOR
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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)
President, Sales & Marketing /
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(Street)
CHICAGO, IL 60654
(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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50230
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D
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Restricted Common Stock
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150750
(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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Stock Options
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5/4/2011
(2)
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5/3/2016
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Common Stock
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100000
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$2.50
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D
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Stock Options
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4/5/2013
(3)
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4/4/2019
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Common Stock
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25000
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$3.09
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D
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Explanation of Responses:
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(
1)
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Restricted Stock Award granted pursuant to the 2005 Equity Incentive Plan (a Rule 16b-3 shareholder approved employee benefit plan) of Merge Healthcare Incorporated. Restrictions on such shares shall lapse and such shares shall become immediately and fully vested to the extent of thirty three percent (33%) of such shares on November 5, 2015 and thirty four percent (34%) of such shares on November 5, 2016, subject to additional terms and conditions as set forth in the restricted stock award agreement.
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(
2)
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Nonqualified stock options to purchase 25,000 shares of Common Stock vesting on each of May 4, 2011, May 4, 2012, May 4, 2013 and May 4, 2014.
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(
3)
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Nonqualified stock options to purchase 6,250 shares of Common Stock vesting on each of April 5, 2014, April 5, 2015, April 5, 2016 and April 5, 2017.
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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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Hammond Kurt R.
350 NORTH ORLEANS STREET
FIRST FLOOR
CHICAGO, IL 60654
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President, Sales & Marketing
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Signatures
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/s/ Julie Ann B. Schumitsch, by Power of Attorney for Kurt R. Hammond
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3/6/2015
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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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