Statement of Changes in Beneficial Ownership (4)
03 Novembre 2021 - 4:28PM
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
*
Young Jeremiah Ray |
2. Issuer Name and Ticker or Trading Symbol
SCI Engineered Materials, Inc.
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SCIA.OB
]
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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) PRESIDENT and CEO |
(Last)
(First)
(Middle)
893 THAYER DRIVE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/3/2021 |
(Street)
GAHANNA, OH 43230
(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, without par value | 11/3/2021 | | M(3) | | 2060 | A | $1.25 | 34544 | D | |
Common stock, without par value | 11/3/2021 | | F(3) | | 486 (1) | D | $5.30 | 34058 | 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 | $1.25 | 11/3/2021 | | M | | | 2060 (2)(4) | 5/15/2021 | 5/14/2028 | Common Stock, without par value | 2060 | $1.25 | 4120 | D | |
Explanation of Responses: |
(1) | Reflects 486 shares withheld by the Issuer at the market price of $5.30 per share less an exercise price of $1.25 per share to fund the cashless exercise of 2,060 options. |
(2) | Stock options under the Issuer's 2011 Stock Option Plan. The option shares are fully vested. |
(3) | The transactions reported above in Table I reflect the cashless exercise of stock options. The cashless exercise for the options is reported in two lines. The lines coded M in column 3 of Table I report in column 4 the number of shares issuable upon exercise of the options had cash been paid to exercise the options, together with the exercise price with Code A for acquired. The lines coded F in column 3 of Table I relates to the same cashless exercise on the preceding line and reports in Column 4 the number of shares deducted from the total number of shares issuable to pay for the cashless exercise of such options with Code D for disposed. |
(4) | Where the number of shares deducted for cashless exercise is a fraction, the number has been rounded to the nearest whole number of shares. The number of shares on a net basis actually owned by the Reporting Person after the cashless exercise of each option is the amount by which the first line for each cashless exercise exceeds the second line for the same cashless exercise. All transactions are exempt from Section 16(b) by reason of Rule 16b-3. The transactions reported in Table II above, reflect the disposition of the same stock options whose cashless exercise is disclosed in Table I above. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Young Jeremiah Ray 893 THAYER DRIVE GAHANNA, OH 43230 |
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| PRESIDENT and CEO |
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Signatures
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/s/ Gerald S Blaskie | | 11/3/2021 |
**Signature of Reporting Person | Date |
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