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) 04/24/2017 | 3. Issuer Name and Ticker or Trading Symbol SITO MOBILE, LTD. [ SITO ] | |||||||||||||
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 | 54,991 | D |
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 | ||||
Performance Stock Options | 11/21/2015(1) | 11/21/2019 | Common Stock | 15,000 | 2.805 | D | |
Performance Stock Options | 11/18/2016(2) | 11/18/2020 | Common Stock | 28,000 | 3.51 | D | |
Stock Options | 05/05/2017(3) | 05/05/2021 | Common Stock | 125,000 | 2.95 | D | |
Performance Stock Options | 08/09/2017(4) | 08/09/2023 | Common Stock | 1,774 | 4 | D | |
Performance Stock Options | 12/22/2017(5) | 12/22/2023 | Common Stock | 25,000 | 3.46 | D | |
Stock Options | 04/24/2017(6) | 04/24/2024 | Common Stock | 75,000 | 2.76 | D |
Explanation of Responses: |
1. The options are performance options granted on November 21, 2014. The options vest and are exercisable in 1/3 increments over a three year period commencing on the first anniversary of the date of grant. |
2. The options are performance options granted on November 18, 2015. The options vest and are exercisable in 1/3 increments over a three year period commencing on the first anniversary of the date of grant. |
3. The options were granted on May 5, 2016; 1/3 vested upon grant, 1/3 shall vest on the first anniversary of the grant date and the remaining 1/3 shall vest on the second anniversary of the grant date. |
4. The options are performance options granted on August 9, 2016. The options vest and are exercisable in 1/3 increments over a three year period commencing on the first anniversary of the date of grant. |
5. The options are performance options granted on December 22, 2016. The options shall vest and become exercisable in 1/3 increments over a three year period commencing on the first anniversary of the date of grant. The maximum number of options subject to the grant shall be 25,000. The number of options to be received by the Reporting Person is dependent upon the achievement of certain corporate goals, determined by the Compensation Committee of the Issuer. |
6. The options were granted on April 24, 2017; 1/3 vested upon grant, 1/3 shall vest on the first anniversary of the grant date and the remaining 1/3 shall vest on the second anniversary of the grant date. |
/s/ Jonathan Lowen | 05/03/2017 | |
** 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 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. |