SEC Form 4
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*
RICKEY DAVID

(Last) (First) (Middle)
3020 CALLAN ROAD

(Street)
SAN DIEGO CA 92121

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CYTORI THERAPEUTICS, INC. [ CYTX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
12/18/2009
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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
Common Stock 12/18/2009(1) X 7,676(1) A $2.62 20,911(2) I By Charitable Foundation(2)
Common Stock 124,800 I By Trust(3)
Common Stock 34,909 I By Family Partnership(4)
Common Stock 4,106 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Warrant to Purchase Common Stock $2.62 05/07/2009(1) X 7,676 05/12/2009(1) 05/12/2014 Common Stock 7,676 $2.28(1) 0 I By Charitable Foundation
Explanation of Responses:
1. On December 18, 2009 the Dave Rickey & Daughters Foundation exercised a Warrant for the purchase of 7,676 shares of the Company's Common stock pursuant to a Securities Purchase Agreement dated May 9, 2009. The Agreement provided for a purchase 4,386 Units ("Unit") at a purchase price of $2.28 per Unit. Each Unit consisted of 1 unregistered share of the Company's Common Stock and a Warrant ("Warrant") to purchase 1.75 shares of Common Stock. The exercise price of the Warrant was $2.62 per share. The Warrant was immediately exercisable upon issuance, and was to expire on the fifth anniversary of its issue date.
2. These securities are owned by the Dave Rickey and Daughters Foundation.
3. These securities are owned by David Rickey, TTEE FBO the David Rickey Trust.
4. These securities are owned by the Rickey Family Limited Partnership.
Remarks:
Jonathan E. Soneff, By Power of Attorney For: David Rickey 12/21/2009
** 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).
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