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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Option to purchase Common Stock | $ 6.33 | 02/16/2021 | A | 50,000 | (2) | 02/15/2031 | Common Stock | 50,000 | $ 0 | 50,000 | D | ||||
10% Senior Convertible Debenture | $ 3.4 | 02/25/2021 | C | 100,000 | 09/07/2018 | (3) | Common Stock | 40,243 | $ 0 | 0 | D | ||||
10% Senior Convertible Debenture | $ 3.4 | 02/25/2021 | C | 30,000 | 06/23/2020 | 06/23/2021 | Common Stock | 9,859 | $ 0 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Breen Michael Martin C/O GT BIOPHARMA, INC 9350 WILSHIRE BLVD., STE. 203 BEVERLY HILLS, CA 90212 |
X |
/s/ Michael Martin Bree | 11/09/2021 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Represents a grant of shares of restricted stock ("RSAs"). 1/3rd of the RSAs vest on January 13, 2021, 2022 and 2023. |
(2) | 1/3rd of the shares vest on February 16, 2021, 2022 and 2023. |
(3) | While the maturity date of the Debenture was September 7, 2019, the Registrant did not repay the Debenture on the maturity date and the Debenture remained outstanding until converted. |