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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 | ||||||||
Warrants (right to buy) | $ 5.5 | 09/02/2016 | P | 9,000 | 09/02/2016(4) | 09/02/2021 | Common Stock | 9,000 | (1) | 9,000 | I | By trust | |||
2009 Note | $ 5 | 09/02/2016 | C | $ 1,000,000 (3) | (3) | (3) | Unit (3) | (3) | $ 5 (3) | 0 | I | By trust | |||
Warrants (right to buy) | $ 5.5 | 09/02/2016 | C | 180,000 | 09/02/2016(4) | 09/02/2021 | Common Stock | 180,000 | (2) | 180,000 | I | By trust | |||
Warrants(5) (right to buy) | $ 5.5 (5) | 03/25/2014 | P | 7,500 | 03/25/2014(4) | 03/25/2019 | Common Stock | 7,500 | (2) | 7,500 | I | By trust |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Rooke Andrew K. C/O MRI INTERVENTIONS, INC. 5 MUSICK IRVINE,, CA 92618 |
X |
/s/ Richard F. Mattern, by Power of Attorney for Andrew K. Rooke | 09/07/2016 | |
**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 reported securities are included within 40,000 units purchased by the Reporting Person for $5.00 per unit. Each unit consists of one share of common stock and one warrant to purchase 0.90 share of common stock. |
(2) | The reported securities are included within 200,000 units sold to the Reporting Person for $5.00 per unit upon the automatic conversion of the $1,000,000 principal balance of the 12% Second-Priority Secured Non-Convertible Promissory Note Due 2019 dated as of March 25, 2014 ("2019 Note") issued to and held by the Reporting Person, as amended by that certain Omnibus Amendment dated as of June 30, 2016 and that certain Second Omnibus Amendment dated as of August 31, 2016 (the "Second Omnibus Amendment"). Each unit consists of one share of common stock and one warrant to purchase 0.90 share of common stock. |
(3) | Upon the closing of the Issuer's private placement on September 2, 2016 (the "Private Placement"), in accordance with the terms and conditions of the Second Omnibus Amendment, the $1,000,000 principal balance of the 2019 Note held by the Reporting Person automatically converted into 200,000 units issued and sold to the Reporting Person based on the $5.00 offering price in the Private Placement. Each unit consists of common stock and one warrant to purchase 0.90 share of common stock. |
(4) | The shares subject to this warrant are immediately exercisable. |
(5) | These warrants were previously reported on the Form 4 filed with the Securities and Exchange Commission on March 26, 2014. This line item reflects the current exercise price of such warrants resulting from anti-dilution adjustments made pursuant to the Second Omnibus Amendment triggered by the Private Placement, on a post reverse stock split basis,. |