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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 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) | 03/10/2017 | A | 105,957 | (3) | 03/10/2027 | Common Stock | 105,957 | $ 0 (4) | 105,957 | D | ||||
Stock Option (right to buy) | (2) | 03/10/2017 | A | 79,468 | (3) | 03/10/2027 | Common Stock | 79,468 | $ 0 (4) | 79,468 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Galvin Paul M. C/O SG BLOCKS, INC., 195 MONTAGUE STREET, 14TH FLOOR BROOKLYN,, NY 11201 |
X | CEO |
/s/ Paul M. Galvin | 03/14/2017 | |
**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) | The options, issued under the issuer's stock incentive plan, will have an exercise price equal to the price per share at which the public purchases shares of common stock in the offering pursuant to which a registration statement on Form S-1 was filed with the Securities and Exchange Commission on February 6, 2017. |
(2) | The options, issued under the issuer's stock incentive plan, will have an exercise price equal to 120% of the price per share at which the public purchases shares of common stock in the offering pursuant to which a registration statement on Form S-1 was filed with the Securities and Exchange Commission on February 6, 2017. |
(3) | The options will vest and become exercisable in two tranches: 50% upon the achievement of the first performance target, and the remaining 50% upon the achievement of the second performance target. |
(4) | The options were granted under the issuer's stock incentive plan and without payment of consideration in connection with the reporting person's employment with the issuer. |
Remarks: * The issuer intends to apply for quotation or listing under this symbol in the future. |