SEC Form 3
| FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF 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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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 07/28/2016 | 3. Issuer Name and Ticker or Trading Symbol Unilife Corp [ UNIS ] | |||||||||||||
| 4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. 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 Beneficially Owned | |||
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| 1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
| Common Stock | 43,207(1) | D | |
| Common Stock | 43,613(2) | I | By spouse. |
| Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Employee Stock Option (right to buy) | (3) | 04/18/2021 | Common Stock | 7,500(3) | 48.4 | D | |
| Explanation of Responses: |
| 1. Of these shares of common stock of Unilife Corporation (the "Company"), 594 shares were awarded by the Company to the reporting person on April 14, 2014 and are scheduled to vest on April 30, 2017 subject to the reporting person's continued employment with the Company as of such date. |
| 2. Of these shares of common stock of the Company, 500 shares were awarded by the Company to the reporting person's spouse on April 15, 2014 and are scheduled to vest on April 30, 2017. Of these shares, 23,188 represent restricted stock units awarded by the Company to the reporting person's spouse on June 30, 2016, 5,797 of which are scheduled to vest on June 1, 2017, 5,797 of which are scheduled to vest on June 1, 2018, and 11,594 of which are scheduled to vest on June 1, 2019, in each case, subject to the reporting person's continued employment with the Company as of the applicable date. |
| 3. On April 18, 2011, the reporting person was granted an option to purchase 7,500 shares of common stock of the Company. The option could vest based on the Company's satisfaction of certain performance criteria through April 18, 2021. Certain performance criteria was met in fiscal year 2013, resulting in vesting of the option as to 2,000 shares. |
| Remarks: |
| VP Quality and Regulatory Affairs & CCO |
| /s/ Kevin Campbell, as attorney-in-fact | 08/08/2016 | |
| ** 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 5 (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. | ||