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)
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2. Date of Event Requiring Statement
(Month/Day/Year) 03/30/2016 |
3. Issuer Name and Ticker or Trading Symbol
ViewRay, Inc. [ VRAY ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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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 | 3,206 | D | |
Common Stock | 98,966(1) | I | See footnote(1) |
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 | ||||
Stock Option (right to buy) | (2) | 12/08/2018 | Common Stock | 4,513 | $0.8 | D | |
Stock Option (right to buy) | (3) | 06/29/2010 | Common Stock | 4,673 | $0.68 | D | |
Stock Option (right to buy) | (4) | 06/29/2020 | Common Stock | 3,703 | $0.68 | D | |
Stock Option (right to buy) | (5) | 03/01/2022 | Common Stock | 2,436 | $0.7 | D | |
Stock Option (right to buy) | (6) | 04/11/2024 | Common Stock | 3,703 | $0.75 | D | |
Stock Option (right to buy) | (7) | 04/11/2024 | Common Stock | 1,032 | $0.75 | D | |
Stock Option (right to buy) | (8) | 07/23/2025 | Common Stock | 19,556 | $5 | D |
Explanation of Responses: |
1. 54,129 shares held by MJSK, Ltd. and 44,837 shares are held by JMSK, Ltd. Janice Gold, the wife of Dr. Gold, is the President of MJSK, Ltd., and Steven Gold, the son of Dr. Gold, is the General Partner of JMSK, Ltd. Voting and dispositive decisions with respect to shares held by MJSK, Ltd. and JMSK, Ltd. are not made by Dr. Gold; he disclaims beneficial ownership of the shares held by MJSK, Ltd. and JMSK, Ltd. except to the extent of any pecuniary interest therein, if any. |
2. One-third (1/3) of the shares subject to the option vest beginning on December 3, 2009, until such shares subject to the option have become fully vested and exercisable. |
3. The shares subject to the option vest in 48 monthly installments beginning on July 14, 2010, until such shares subject to the option have become fully vested and exercisable. |
4. The shares subject to the option vest in 36 monthly installments beginning on June 17, 2010, until such shares subject to the option have become fully vested and exercisable. |
5. The shares subject to the option vest in 48 monthly installments on each monthly anniversary of March 1, 2012, until such shares subject to the option have become fully vested and exercisable. |
6. The shares subject to the option vest in 48 monthly installments on the first calendar day of each month following May 13, 2013, until such shares subject to the option have become fully vested and exercisable. |
7. The shares subject to the option vest in 48 monthly installments on the first calendar day of each month following November 13, 2013, until such shares subject to the option have become fully vested and exercisable. |
8. The shares subject to the option vest in 12 monthly installments on each monthly anniversary of July 23, 2015, until such shares subject to the option have become fully vested and exercisable. |
/s/ Wesley Mintu, Wesley Mintu, as Attorney-in-Fact for Mark S. Gold | 03/30/2016 | |
** 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. |