Statement of Changes in Beneficial Ownership (4)
October 16 2020 - 5:05PM
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
*
Clasby Jennifer G |
2. Issuer Name and Ticker or Trading Symbol
EYENOVIA, INC.
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EYEN
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) VP, Clinical Operations |
(Last)
(First)
(Middle)
C/O EYENOVIA, INC., 295 MADISON AVENUE, SUITE 2400 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
9/18/2020 |
(Street)
NEW YORK, NY 10017
(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 | 9/18/2020 | | M | | 26737 | A | $1.95 | 55702 | 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 |
Stock Option (right to buy) | $1.95 | 9/18/2020 | | M | | | 26737 | (1) | 7/7/2027 | Common Stock | 26737 | $0.00 | 24510 | D | |
Stock Option (right to buy) | $6.20 | | | | | | | (2) | 7/24/2028 | Common Stock | 19874 | | 19874 | D | |
Stock Option (right to buy) | $3.11 | | | | | | | (3) | 8/16/2029 | Common Stock | 42722 | | 42722 | D | |
Stock Option (right to buy) | $2.72 | | | | | | | (4) | 6/2/2030 | Common Stock | 121410 | | 121410 | D | |
Explanation of Responses: |
(1) | The option became exercisable as to 2,228 shares on August 7, 2017 and becomes exercisable in equal 2,228 share amounts on each of the 35 one-month anniversaries thereafter. |
(2) | One-third of the option becomes exercisable on July 24, 2019 and the remaining shares underlying the option become exercisable in equal increments on each of the 24 one-month anniversaries thereafter. |
(3) | One-third of the option becomes exercisable on August 16, 2020 and the remaining shares underlying the option become exercisable in equal increments on each of the 24 one-month anniversaries thereafter. |
(4) | This stock option was granted by the Issuer's Board of Directors on June 3, 2020, subject to stockholder approval of the Issuer's Amended and Restated 2018 Omnibus Stock Incentive Plan (the "Plan"). The Issuer's stockholders approved the Plan on June 30, 2020. One-third of the option becomes exercisable on June 3, 2021 and the remaining shares underlying the option become exercisable in equal increments on each of the 24 one-month anniversaries thereafter. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Clasby Jennifer G C/O EYENOVIA, INC. 295 MADISON AVENUE, SUITE 2400 NEW YORK, NY 10017 |
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| VP, Clinical Operations |
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Signatures
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/s/ S. Halle Vakani, Attorney-in-Fact | | 10/16/2020 |
**Signature of Reporting Person | Date |
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