0000914190-18-000139.txt : 20180412 0000914190-18-000139.hdr.sgml : 20180412 20180412161250 ACCESSION NUMBER: 0000914190-18-000139 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180410 FILED AS OF DATE: 20180412 DATE AS OF CHANGE: 20180412 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Evans Daron CENTRAL INDEX KEY: 0001411726 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32288 FILM NUMBER: 18752230 MAIL ADDRESS: STREET 1: C/O NEPHROS, INC. STREET 2: 41 GRAND AVENUE CITY: RIVER EDGE STATE: NJ ZIP: 07661 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NEPHROS INC CENTRAL INDEX KEY: 0001196298 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 133971809 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 380 LACKAWANNA PLACE CITY: SOUTH ORANGE STATE: NJ ZIP: 07079 BUSINESS PHONE: 201.343.5202 MAIL ADDRESS: STREET 1: 380 LACKAWANNA PLACE CITY: SOUTH ORANGE STATE: NJ ZIP: 07079 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2018-04-10 0001196298 NEPHROS INC NEPH 0001411726 Evans Daron C/O NEPHROS, INC. 380 LACKAWANNA PLACE SOUTH ORANGE NJ 07079 1 1 0 0 President and CEO Common Stock 892958 D Common Stock 2018-04-10 4 P 0 55000 .45 A 55000 I By PoC Capital, LLC Common Stock 2018-04-10 4 P 0 12000 .45 A 65666 I By UTMA #1 Common Stock 2018-04-10 4 P 0 12000 .45 A 63166 I By UTMA #2 Stock Option (Right to Buy) .46 2024-03-26 Common Stock 75361 75361 D Stock Option (Right to Buy) .60 2025-04-15 Common Stock 982887 982887 D Stock Option (Right to Buy) .4999 2027-12-20 Common Stock 837125 837125 D Common Stock Warrants (Right to Buy) .30 2016-06-03 2021-06-03 Common Stock 40000 40000 I By PoC Capital, LLC Common Stock Warrants (Right to Buy) .30 2016-06-03 2021-06-03 Common Stock 10000 10000 I By UTMA #1 Common Stock Warrants (Right to Buy) .30 2016-06-03 2021-06-03 Common Stock 10000 10000 I By UTMA #2 Common Stock Warrants (Right to Buy) .30 2017-03-17 2022-03-17 Common Stock 41666 41666 I By UTMA #1 Common Stock Warrants (Right to Buy) .30 2017-03-17 2022-03-17 Common Stock 41666 41666 I By UTMA #2 Includes 180,000 shares of restricted stock that vest on 6/20/18. The Reporting Person is a managing director of the LLC that owns the reported securities. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. Fully exercisable. On 4/15/2015, the Reporting Person was granted an option to purchase up to 2,184,193 shares of common stock of the Company. 35% of the shares subject to the option (relating to a total of 764,468 shares) vest quarterly in 16 equal amounts, commencing on 6/30/2015. 15% of the shares subject to the option will vest, if ever, upon the listing of the Company's common stock on NASDAQ, NYSE, or such other exchange as the Board may later determine. The remaining 50% of the shares subject to the option will vest, if ever, upon the Company's achievement of certain annual revenue milestones as specified in that certain Employment Agreement dated 4/15/2015 between the Reporting Person and the Company. The Company achieved the $3,000,000 annual revenue milestone in fiscal year 2017 and options to purchase 218,419 shares vested on 2/1/18. On 12/20/17, the Reporting Person was granted an option to purchase 837,125 shares of common stock of the Company. 25% of the shares subject to the option (relating to a total of 209,282 shares) vest on 12/20/18 and the remaining 75% of the shares subject to the option (relating to a total of 627,843 shares) vest quarterly in 12 equal amounts, commencing on 3/20/19. /s/ Daron Evans 2018-04-12