UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Option (right to buy) | Â (2) | 09/11/2016 | Common Stock | 50,000 | $ 0.6 | D | Â |
Stock Option (right to buy) | Â (3) | 09/30/2020 | Common Stock | 97,500 | $ 4.32 | D | Â |
Stock Option (right to buy) | Â (4) | 09/26/2021 | Common Stock | 27,500 | $ 5.26 | D | Â |
Stock Option (right to buy) | Â (5) | 09/26/2021 | Common Stock | 5,531 | $ 5.26 | D | Â |
Stock Option (right to buy) | Â (6) | 03/26/2022 | Common Stock | 27,500 | $ 5.5 | D | Â |
Stock Option (right to buy) | Â (7) | 03/27/2022 | Common Stock | 4,297 | $ 5.5 | D | Â |
Stock Option (right to buy) | Â (8) | 08/03/2024 | Common Stock | 45,000 | $ 8.96 | D | Â |
Stock Option (right to buy) | Â (9) | 08/03/2024 | Common Stock | 45,000 | $ 10.96 | D | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Steines Daniel C/O CONFORMIS, INC. 28 CROSBY DRIVE BEDFORD, MA 01730 |
 |  |  Chief Technology Officer |  |
/s/ Lan Marinelli, Attorney-in-Fact | 06/30/2015 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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 shares are held directly by the Steines 2011 Family Trust. The Reporting Person's children are beneficiaries of the Steines 2011 Family Trust, and the Reporting Person disclaims beneficial ownership of all shares except to the extent of his pecuniary interest therein. |
(2) | This option is fully vested. |
(3) | This option is fully vested. |
(4) | This option is fully vested. |
(5) | This option is fully vested. |
(6) | The option was granted on March 27, 2012 and vests over one year, with 8.3333% of the shares underlying the option vesting monthly after January 1, 2015. |
(7) | This option is fully vested. |
(8) | This option was granted on August 4, 2014 and vests over four years, with 2.0833% of the shares underlying the option vesting monthly after April 1, 2014. |
(9) | This option was granted on August 4, 2014 and vests over four years, with 2.0833% of the shares underlying the option vesting monthly after April 1, 2014. |
 Remarks: Exhibit 24 - Power of Attorney |