Statement of Changes in Beneficial Ownership (4)
19 Mars 2022 - 12:23AM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
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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Seabaugh Ramona |
2. Issuer Name and Ticker or Trading Symbol
MedAvail Holdings, Inc.
[
MDVL
]
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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) Chief Financial Officer |
(Last)
(First)
(Middle)
C/O MEDAVAIL HOLDINGS, INC., 6665 MILLCREEK DR. UNIT 1 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/16/2022 |
(Street)
MISSISSAUGA L5N 5M4
(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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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) | $0.83 | 3/16/2022 | | A | | 60000 | | (1) | 3/16/2032 | Common Stock | 60000.0 | $0 | 60000 | D | |
Restricted Stock Units | (2) | 3/16/2022 | | A | | 60000 | | (3) | (3) | Common Stock | 60000.0 | $0 | 60000 | D | |
Explanation of Responses: |
(1) | 12/48th of the Shares subject to the Option shall vest one year after March 16, 2022, and 1/48th of the Shares subject to the Option shall be scheduled to vest each month thereafter on the same day of the month as March 16, 2022 (or the last day of the month, if there is no corresponding day in a given month), in each case subject to the Recipient remaining a Service Provider (as defined in the Plan) through the applicable vesting date. |
(2) | Each restricted stock unit represents a contingent right to receive on share of MDVL common stock. |
(3) | One third (1/3rd) of the shares subject to the RSU shall be scheduled to vest on each of the one (1), two (2), and three (3) year anniversaries of March 1, 2022 such that the RSU shall be scheduled to become fully vested on the three (3) year anniversary of the Vesting Commencement Date, in each case subject to the Recipient remaining a Service Provider (as defined in the Plan) through the applicable vesting date. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Seabaugh Ramona C/O MEDAVAIL HOLDINGS, INC. 6665 MILLCREEK DR. UNIT 1 MISSISSAUGA L5N 5M4 |
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| Chief Financial Officer |
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Signatures
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/s/ Ramona Seabaugh | | 3/18/2022 |
**Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* | 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). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
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. |
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