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) 06/19/2018 | 3. Issuer Name and Ticker or Trading Symbol Fibrocell Science, Inc. [ FCSC ] | |||||||||||||
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) |
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 | (1) | 01/14/2021 | Common Stock | 200 | 232.5 | D | |
Option to Purchase Common Stock | (2) | 07/19/2023 | Common Stock | 334 | 82.35 | D | |
Option to Purchase Common Stock | (3) | 04/01/2025 | Common Stock | 1,000 | 63.6 | D | |
Option to Purchase Common Stock | (4) | 09/27/2026 | Common Stock | 2,229 | 11.25 | D | |
Option to Purchase Common Stock | (5) | 03/16/2027 | Common Stock | 4,000 | 11.25 | D | |
Option to Purchase Common Stock | (6) | 01/25/2028 | Common Stock | 5,000 | 3.45 | D |
Explanation of Responses: |
1. The option vested as follows: (i) 100 shares on January 14, 2011 and (ii) 50 shares on each of January 14, 2012 and January 14, 2013. |
2. The option vested in four equal installments on July 19, 2013, July 19, 2014, July 19, 2015 and July 19, 2016. |
3. The option vests in four equal installments on April 1, 2016, April 1, 2017, April 1, 2018 and April 1, 2019 provided the reporting person is employed by Fibrocell Science, Inc., (the "Company") on each vesting date. |
4. The option vests as follows (i) 558 shares on September 27, 2017 and (ii) the remaining shares in twelve equal quarterly installments beginning on December 27, 2017 and ending on September 27, 2020 provided the reporting person is employed by the Company on each vesting date. |
5. The option vests as follows: (i) 1,000 shares on March 16, 2018 and (ii) the remaining shares in twelve equal quarterly installments beginning on June 16, 2018 and ending on March 16, 2021 provided the reporting person is employed by the Company on each vesting date. |
6. The option vests as follows: (i) 1,250 shares on January 25, 2019 and (ii) the remaining shares in twelve equal quarterly installments beginning on April 25, 2019 and ending on January 25, 2022 provided the reporting person is employed by the Company on each vesting date. |
Remarks: |
Vice President of Business Administration and Corporate Secretary |
/s/ Sean D. Buckley | 06/27/2018 | |
** 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. |