Statement of Changes in Beneficial Ownership (4)
March 11 2021 - 6:20PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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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
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Wulf Sylvia |
2. Issuer Name and Ticker or Trading Symbol
AquaBounty Technologies, Inc.
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AQB
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner
__X__ Officer (give title below) _____ Other (specify below)
CEO & Director |
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(Last)
(First)
(Middle)
C/O AQUABOUNTY TECHNOLOGIES, INC., 2 MILL & MAIN PLACE, SUITE 395 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/10/2021 |
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(Street)
MAYNARD, MA 01754
(City)
(State)
(Zip)
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4. 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 Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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| Common Stock | | | | | | | | 164088 | D | |
| Common Stock | | | | | | | | 36170 (1) | D | |
| Common Stock | 3/10/2021 | | A | | 9196 | A | $0.00 | 9196 (2) | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security
(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) |
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Options to Purchase Common Stock | $2.22 | | | | | | | 4/30/2020 (3) | 4/30/2029 | Common Stock | 150000 | | 150000 | D | |
| Options to Purchase Common Stock | $1.88 | | | | | | | 3/12/2023 (4) | 3/12/2030 | Common Stock | 31649 | | 31649 | D | |
| Options to Purchase Common Stock | $6.72 | 3/10/2021 | | A | | 8047 | | 3/10/2024 (5) | 3/10/2031 | Common Stock | 8047 | $0.00 | 8047 | D | |
| Explanation of Responses: |
| (1) | Award of restricted stock granted on 3/12/2020 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan that vests immediately as to 1/3 of the grant, with an additional 1/3 vesting 1 year after the grant, and the final 1/3 vesting 2 years after the date of grant. |
| (2) | Award of restricted stock granted on 3/10/2021 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan that vests immediately as to 1/3 of the grant, with an additional 1/3 vesting 1 year after the grant, and the final 1/3 vesting 2 years after the date of grant. |
| (3) | Options to purchase common stock were granted on 4/30/2019 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan and are fully vested. |
| (4) | Options to purchase common stock were granted on 3/12/2020 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan and fully vest three years after the date of grant. |
| (5) | Options to purchase common stock were granted on 3/10/2021 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan and fully vest three years after the date of grant. |
Remarks:
Director, Chief Executive Officer, and President |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Wulf Sylvia
C/O AQUABOUNTY TECHNOLOGIES, INC.
2 MILL & MAIN PLACE, SUITE 395
MAYNARD, MA 01754 | X |
| CEO & Director |
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Signatures
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| /s/ David A. Frank, Name: David A. Frank, attorney-in-fact | | 3/11/2021 |
| **Signature of Reporting Person | Date |
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