0001753926-23-000259.txt : 20230308 0001753926-23-000259.hdr.sgml : 20230308 20230308213214 ACCESSION NUMBER: 0001753926-23-000259 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230306 FILED AS OF DATE: 20230308 DATE AS OF CHANGE: 20230308 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mendelsohn Adam CENTRAL INDEX KEY: 0001940008 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36747 FILM NUMBER: 23717995 MAIL ADDRESS: STREET 1: C/O 5858 HORTON ST. SUITE 280 CITY: EMERYVILLE STATE: CA ZIP: 94608 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Vivani Medical, Inc. CENTRAL INDEX KEY: 0001266806 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 000000000 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5858 HORTON STREET, SUITE 280 CITY: EMERYVILLE STATE: CA ZIP: 94608 BUSINESS PHONE: 818-833-5000 MAIL ADDRESS: STREET 1: 5858 HORTON STREET, SUITE 280 CITY: EMERYVILLE STATE: CA ZIP: 94608 FORMER COMPANY: FORMER CONFORMED NAME: SECOND SIGHT MEDICAL PRODUCTS INC DATE OF NAME CHANGE: 20031010 4 1 ownership.xml X0306 4 2023-03-06 0 0001266806 Vivani Medical, Inc. VANI 0001940008 Mendelsohn Adam C/O 5858 HORTON ST. SUITE 280 EMERYVILLE CA 94608 1 1 0 0 CEO Common Stock Option 1.09 2023-03-06 4 A 0 200000 0 A 2023-03-06 2033-03-06 Common Stock 200000 200000 D RSU 2023-03-06 4 A 0 100000 0 A 2023-03-06 2027-03-06 Common Stock 100000 100000 D Each RSU represents a contingent right to receive one share of Vivani common stock. The stock options have a 10-year term and vest immediately when share price closes at $6.30 for three consecutive business days. If the options fail to reach $6.30 for three consecutive business days within a four year term from the date of grant the options expire. First third of RSUs vest when the stock price is at or above $3.15 for three consecutive business days. Second third vests one year after that. Final third vests one year after the second third. If the RSUs fail to reach $3.15 for three consecutive business days within a four year term from the date of the grant the RSUs expire. /s/ Adam Mendelsohn 2023-03-08