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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 | ||||||||
Stock Option (Right to Buy) | $ 1.56 | 09/19/2017 | A | 50,000 | (1) | 09/19/2027 | Common Stock | 50,000 | $ 0 | 50,000 | D | ||||
Warrant | $ 4 | 09/15/2017 | D | 25,000 | 12/01/2017 | 04/30/2021 | Common Stock | 25,000 | $ 0 (2) | 0 | I | By Jermax, LLC | |||
Warrant | $ 4 | 09/15/2017 | D | 25,000 | 12/01/2017 | 04/30/2021 | Common Stock | 25,000 | $ 0 (2) | 0 | I | By Spouse | |||
Warrant | $ 2 | 09/15/2017 | A | 25,000 | 12/01/2017 | 04/30/2021 | Common Stock | 25,000 | $ 0 (2) | 25,000 | I | By Jermax, LLC | |||
Warrant | $ 2 | 09/15/2017 | A | 25,000 | 12/01/2017 | 04/30/2021 | Common Stock | 25,000 | $ 0 (2) | 25,000 | I | By Spouse | |||
Warrant | $ 2 | 09/15/2017 | A | 25,000 | 05/19/2018 | 04/30/2021 | Common Stock | 25,000 | $ 0 (2) | 25,000 | I | By Jermax, LLC | |||
Warrants | $ 2 | 09/15/2017 | A | 25,000 | 05/19/2018 | 04/30/2021 | Common Stock | 25,000 | $ 0 (2) | 25,000 | I | By Spouse |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
GIN JERRY B C/O VISTAGEN THERAPEUTICS, INC. 343 ALLERTON AVENUE SOUTH SAN FRANCISCO, CA 94080 |
/s/ Jerrold D. Dotson, Attorney-in-Fact | 10/06/2017 | |
**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) | 1/3rd of the total number of shares shall be immediately vested upon the Vesting Start Date, 9/19/2017, and 1/24th of the remaining number of shares shall vest monthly thereafter until all awarded shares are fully vested two (2) years from the Vesting Start Date. |
(2) | This Amendment to the Form 4 originally filed by the Reporting Person on September 20, 2017 (the "Original Filing") is being filed to report (i) the reduction of the exercise price of warrants purchased by Jermax, LLC, an entity controlled by the Reporting Person ("Jermax"), and the Reporting Person's spouse from the Issuer on May 31, 2017 in a private placement transaction (the "Initial Warrants") and (ii) the issuance of additional warrants to Jermax and the Reporting Person's spouse (the "Additional Warrants"). The Issuer's Board of Directors approved the reduction of the exercise price from $4.00 per share to $2.00 per share for the Initial Warrants and all other warrants issued in the same private placement (the "Spring 2017 Private Placement"), and the issuance of the Additional Warrants and warrants similar to the Additional Warrants for all other participants in the Spring 2017 Private Placement. |