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) 07/09/2018 | 3. Issuer Name and Ticker or Trading Symbol ZYNEX INC [ ZYXI ] | |||||||||||||
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 | 10,000(1) | D | |
Common Stock | 5,000(2) | D | |
Common Stock | 5,000(3) | D | |
Common Stock | 5,000(4) | 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 | ||||
Option to Purchase Common Stock) | 06/05/2018 | 06/05/2027 | A | 200,000(5) | 0.4 | D | |
Option to Purchase Common Stock | 09/05/2018 | 09/05/2027 | A | 10,000(6) | 1.39 | D | |
Option to Purchase Common Stock | 12/11/2018 | 12/11/2027 | A | 57,260(7) | 2.5 | D |
Explanation of Responses: |
1. Represents a restricted stock award issued pursuant to the Issuer's 2017 Stock Incentive Plan (the "Plan") on June 5, 2017, of which 2,500 shares are vested and which such total award vests in four equal annual installments beginning on the one year anniversary of the issue date |
2. Represents a restricted stock award issued pursuant to the Plan on December 11, 2017, of which no shares are vested and which such total award vests in four equal annual installments beginning on the one year anniversary of the issue date |
3. Represents a restricted stock award issued pursuant to the Plan on March 5, 2018, of which no shares are vested and which such total award vests in four equal annual installments beginning on the one year anniversary of the issue date. |
4. Represents a restricted stock award issued pursuant to the Plan on June 5, 2018, of which no shares are vested and which such total award vests in four equal annual installments beginning on the one year anniversary of the issue date. |
5. Represents an option to purchase 200,000 shares of common stock issued pursuant to the Plan on June 5, 2017, of which options to purchase 50,000 shares of common stock are vested and which such total option vests in four equal annual installments beginning on the one year anniversary of the issue date. |
6. Represents an option to purchase 10,000 shares of common stock issued pursuant to the Plan on September 5, 2017, of which no options are vested and which such total option vests in four equal annual installments beginning on the one year anniversary of the issue date. |
7. Represents an option to purchase 57,260 shares of common stock issued pursuant to the Plan on December 11, 2017, of which no options are vested and which such total option vests in four equal annual installments beginning on the one year anniversary of the issue date. |
/s/ Daniel Moorhead | 07/09/2018 | |
** 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. |