| FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol LAPOLLA INDUSTRIES INC [ LPAD ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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| 3. Date of Earliest Transaction (Month/Day/Year) 11/30/2017 | ||||||||||||||||||||||||||
| 4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
| Code | V | Amount | (A) or (D) | Price | ||||||
| Common Stock, PV $.01 | 11/30/2017 | D | 100,000 | D | $1.03(1) | 0 | D | |||
| Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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| 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 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: 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 | ||||||||
| Option (Right to Buy) | $0.65 | 11/30/2017 | D | 100,000 | (2) | 02/07/2019 | Common Stock | 100,000 | (2) | 0 | D | ||||
| Option (Right to Buy) | $0.42 | 11/30/2017 | D | 150,000 | (3) | 04/28/2019 | Common Stock | 150,000 | (3) | 0 | D | ||||
| Option (Right to Buy) | $0.41 | 11/30/2017 | D | 300,000 | (4) | 03/23/2023 | Common Stock | 300,000 | (4) | 0 | D | ||||
| Explanation of Responses: |
| 1. Effective November 30, 2017, pursuant to that certain Agreement and Plan of Merger, dated October 4, 2017, by and among Icynene U.S. Holding Corp. ("Parent"), Blaze Merger Sub Inc., a wholly owned subsidiary of Parent ("Merger Sub"), and Lapolla Industries, Inc. (the "Issuer"), Merger Sub merged with and into the Issuer, with the Issuer continuing as the surviving corporation and as a wholly owned subsidiary of Parent (the "Merger"). As consideration for the Merger, each share of Issuer common stock was cancelled and extinguished and converted into the right to receive $1.03 in cash (the "Per Share Merger Consideration"). |
| 2. This option, which provided for vesting in three equal annual installments beginning on February 6, 2015, was cancelled in the Merger in exchange for a cash payment of $38,000, representing, for each share for which the option was exercisable, the difference between the exercise price of the option and the Per Share Merger Consideration. |
| 3. This option, which provided for vesting in three equal annual installments beginning on December 31, 2014, was cancelled in the Merger in exchange for a cash payment of $91,500, representing, for each share for which the option was exercisable, the difference between the exercise price of the option and the Per Share Merger Consideration. |
| 4. This option, which provided for vesting in three equal annual installments beginning on December 31, 2015, was cancelled in the Merger in exchange for a cash payment of $186,000, representing, for each share for which the option was exercisable, the difference between the exercise price of the option and the Per Share Merger Consideration. |
| Remarks: |
| /s/ Harvey L. Schnitzer | 11/30/2017 | |
| ** 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 Number. | ||
