SEC Form 3
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*
Purtill Geoffrey

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

(Street)
ELYRIA OH 44035

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
12/01/2021
3. Issuer Name and Ticker or Trading Symbol
INVACARE CORP [ IVC ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP & GM, EMEA & Asia Pacific
5. 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 Beneficially Owned
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 Shares 54,354(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Employee Stock Option (Right to Buy) (2) 08/14/2022 Common Shares 3,300 $13.37 D
Employee Stock Option (Right to Buy) (2) 03/18/2023 Common Shares 5,000 $14.49 D
Employee Stock Option (Right to Buy) (2) 03/16/2027 Common Shares 17,611 $12.15 D
Explanation of Responses:
1. Includes 8,674 restricted stock units granted pursuant to the Invacare Corporation 2018 Equity Compensation Plan in exempt transactions under Rule 16b-3. 1,804 of these restricted stock units vest in full on May 15, 2022; 2,850 of these restricted stock units vest in 1/2 increments on May 15, 2022 and May 15, 2023; and 4,020 of these restricted stock units vest in 1/3 increments on May 15, 2022, May 15, 2023 and May 15, 2024.
2. Immediately exercisable.
Remarks:
/s/ Kristofer K. Spreen as attorney-in-fact for Geoffrey Purtill under Power of Attorney 12/03/2021
** 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.