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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 | ||||||||
non-qualified stock options | $ 0.77 | 09/15/2009 | 09/14/2014 | common stock | 15,000 | 15,000 | D | ||||||||
non-qualified stock options | $ 4.16 | 09/14/2011 | 09/13/2017 | common stock | 6,175 | 6,175 | D | ||||||||
non-qualified stock options | $ 4.83 | 09/14/2012 | 09/13/2018 | common stock | 5,475 | 5,475 | D | ||||||||
non-qualified stock options | $ 3.76 | 09/13/2013 | 09/12/2019 | common stock | 7,025 | 7,025 | D | ||||||||
non-qualifed stock option | $ 3.46 | 09/12/2014 | 09/11/2020 | common stock | 8,625 | 8,625 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MAXWELL ROBERT PATRICK UROPLASTY, INC. 5420 FELTL ROAD MINNETONKA, MN 55343 |
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Larry Bakeman | 12/12/2013 | |
**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) | Includes 4,350 shares of restricted stock subject to risk of forfeiture that lapses on March 12, 2014 (six months after the grant date). |
(2) | The reporting person's purchase of 3,819 shares of the issuer's common stock reported herein was potentially in violation of the issuer's insider trading guidelines. In an effort to remedy any potential violation of the issuer's insider trading guidelines, the reporting person sold 3,819 shares of the issuer's common stock as reported herein. However, the reported purchase and sale were matchable under Section 16(b) of the Securities Exchange Act of 1934, as amended. Accordingly, the reporting person has agreed to pay to the issuer $763.80, representing the full amount of the profit realized by the reporting person in connection with the short-swing transaction. |
Remarks: Signature is on behalf of Mr. Maxwell. |