| 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 CorMedix Inc. [ CRMD ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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| 3. Date of Earliest Transaction (Month/Day/Year) 10/03/2016 | ||||||||||||||||||||||||||
| 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 | ||||||
| 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 | ||||||||
| Stock Option (right to buy) | $2.52 | 10/03/2016 | A | 1,250,000 | (1) | 10/03/2026 | Common Stock | 1,250,000 | $0 | 1,250,000 | D | ||||
| Stock Option (right to buy) | $2.52 | 10/03/2016 | A | 300,000 | (2) | 10/03/2026 | Common Stock | 300,000 | $0 | 300,000 | D | ||||
| Stock Option (right to buy) | $2.52 | 10/03/2016 | A | 300,000 | (3) | 10/03/2026 | Common Stock | 300,000 | $0 | 300,000 | D | ||||
| Explanation of Responses: |
| 1. The option vests as follows: 25% on 10/3/2017, 25% on 10/3/2018, 25% on 10/3/2019, and 25% on 10/3/2020. |
| 2. The option vests on the date the Company?s common stock attains an average closing price over any period of 30 consecutive trading days equal to or greater than 2.75 times the closing price per share on the lesser of 9/23/16 or 10/3/16 (the ?Stock Price Condition"); provided, that if the Stock Price Condition is met prior to 12/31/18 then the option will not vest until 12/31/18. The option will be forfeited (i) if the stock price on 12/31/18 is below the closing price per share on the lesser of 9/23/16 or 10/3/16, or (ii) if the Stock Price Condition is not met by 10/3/2020. |
| 3. The option vests based on certain performance milestones. If such milestones are met prior to 12/31/18, then the option will not vest until 12/31/18. The option will be forfeited if such milestones are not met by 10/3/2020. |
| /s/ Khoso Baluch | 10/05/2016 | |
| ** 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 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. | ||
