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*
Zavracky Paul M

(Last) (First) (Middle)
ONE TECH DRIVE
STE 325

(Street)
ANDOVER MA 01810

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MEMSIC Inc [ MEMS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President, NA & EU Operations
3. Date of Earliest Transaction (Month/Day/Year)
09/17/2013
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 09/17/2013 S 47,524 D $4.225(1) 0 D
Common Stock 09/17/2013 S 30,000 D $4.225(2) 0 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
Stock Option (right to buy) $0.3 09/17/2013 S 30,000 10/01/2007 10/01/2013 Common Stock 30,000(3) $4.225 0 D
Stock Option (right to buy) $0.3 09/17/2013 S 45,000 04/28/2009 04/28/2015 Common Stock 45,000(3) $4.225 0 D
Stock Option (right to buy) $1.75 09/17/2013 S 12,000 03/12/2013 03/12/2019 Common Stock 12,000(3) $4.225 0 D
Stock Option (right to buy) $3.35 09/17/2013 S 12,000 05/12/2014 05/12/2020 Common Stock 12,000(3) $4.225 0 D
Stock Option (right to buy) $3.41 09/17/2013 S 100,000 04/04/2015 04/04/2021 Common Stock 100,000(3) $4.225 0 D
Stock Option (right to buy) $2.15 09/17/2013 S 140,000 05/20/2016 05/20/2022 Common Stock 140,000(3) $4.225 0 D
Stock Option (right to buy) $6.4 09/17/2013 J 12,000 03/12/2012 03/12/2018 Common Stock 12,000(4) $0 0 D
Explanation of Responses:
1. Pursuant to the terms of the Agreement and Plan of Merger, dated April 22, 2013, by and among MZ Investment Holdings Limited ("Parent"), MZ Investment Holdings Merger Sub Limited and MEMSIC, Inc. (the "Merger Agreement"; capitalized terms used but not defined herein have the meanings assigned to them in the Merger Agreement), at the Effective Time, each share of common stock of the Company held by the Reporting Person was cancelled and converted automatically into the right to receive $4.225 in cash. In connection with the closing of the Merger, the Reporting Person rolled over certain of their existing equity interests in the Company into equity shares of Parent.
2. Pursuant to the terms of the Merger Agreement, at the Effective Time, the RSUs held by the Reporting Person were converted into the right to receive an amount in cash equal to $4.225 per RSU. Pursuant to a rollover agreement entered into between Parent and the Reporting Person, certain RSUs held by the Reporting Person were converted into equity shares of Parent.
3. Pursuant to the terms of the Merger Agreement, at the Effective Time, the Company Options held by the reporting person were converted into the right to receive an amount in cash equal to the product of (i) the excess, if any, of $4.225 per Common Share over the exercise price per Common Share of such Company Option multiplied by (ii) the total number of Common Shares subject to such Company Options (without regard to vesting). Pursuant to a rollover agreement entered into between Parent and the Reporting Person, certain Company Options held by the Reporting Person were converted into equity shares of Parent.
4. Pursuant to the terms of the Merger Agreement, at the Effective Time, out of money stock options were canceled.
/s/ Patricia Niu, attorney-in-fact 09/19/2013
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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