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*
Danielsohn-Weil Petra

(Last) (First) (Middle)
ONE INVACARE WAY

(Street)
ELYRIA OH 44035

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
INVACARE HOLDINGS Corp [ IVCRQ ]
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)
05/05/2023
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 Shares 05/05/2023 J(1)(2) 52,462 D $0.00(1)(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
Explanation of Responses:
1. On January 31, 2023, Invacare Corporation (the "Issuer") and certain of its direct and indirect subsidiaries (collectively with the Issuer, the "Debtors") filed a voluntary petition (the "Chapter 11 Cases") under chapter 11 of the U.S. Bankruptcy Code (the "Bankruptcy Code") in the U.S. Bankruptcy Court for the Southern District of Texas (the "Bankruptcy Court") and on April 28, 2023 the Bankruptcy Court entered an order (the "Confirmation Order") confirming the chapter 11 plan of reorganization of the Debtors in their chapter 11 cases (the "Plan"). On May 5, 2023 (the "Effective Date"), the Plan was consummated and became effective in accordance with its terms and the Debtors emerged from the Chapter 11 Cases.
2. (Continued from footnote 1) On the Effective Date, in connection with the satisfaction of the conditions to effectiveness set forth in the Confirmation Order and in the Plan, the Issuer completed a series of transactions pursuant to which, among other things, the Issuer merged with a wholly owned subsidiary of Invacare Holdings Corporation, a Delaware corporation ("New Parent"), and (i) all of the Issuer's common shares outstanding prior to the Effective Date were canceled, released, and extinguished, and of no further force or effect and (ii) all of the Issuer's equity award agreements under any incentive plan, and the awards granted pursuant thereto, were extinguished, canceled, and discharged and have no further force or effect. New Parent is the successor to the Issuer pursuant to Rule 12g-3 under the Securities Exchange Act of 1934, as amended. Accordingly, this Form 4 shall constitute an exit filing for the Reporting Person with respect to the Issuer.
Remarks:
/s/ Petra Danielsohn-Weil, by Kristofer K. Spreen, her attorney-in-fact, pursuant to Power of Attorney, dated May 11, 2018, on file with the Commission 05/05/2023
** 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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