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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Novalere Holdings, LLC 151 TREMONT ST., PENTHOUSE BOSTON, MA 02111 |
X |
/s/ Robert Kargman, Manager of Novalere Holdings, LLC | 12/02/2016 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The reporting person acquired the shares in connection with the entry on Nov. 30, 2016 into an Amendment and Supplement to the Registration Rights and Stock Restriction Agreement by and among the Issuer and the reporting person dated Feb. 4, 2015, as amended by a First Amendment to Amendment and Supplement (collectively, the "Amendment"). The Amendment amended and supplemented certain of the demand and piggy-back registrations rights granted to the reporting person pursuant to the Registration Rights and Stock Restriction Agreement between the Issuer and the reporting person dated Feb. 4, 2015 (the "Rights Agreement"). The Rights Agreement was entered into in connection with the acquisition of Novalere FP, Inc. ("Novalere") by the Issuer (the "Merger"). As a result of the Merger, all of the outstanding shares of Novalere common stock were converted into the right to receive shares of the Issuer's common stock. The reporting person is a former stockholder of Novalere. |
(2) | The shares were issued in consideration for entry into the Amendment and Supplement, which includes a waiver of certain of the reporting person's rights with respect to registration of shares of Issuer held by the reporting person and a release of claims in favor of Issuer with respect to any failure of Issuer to achieve certain milestones set forth in the Agreement and Plan of Merger dated February 4, 2015. |