0001628280-21-012675.txt : 20210622
0001628280-21-012675.hdr.sgml : 20210622
20210622172740
ACCESSION NUMBER: 0001628280-21-012675
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210617
FILED AS OF DATE: 20210622
DATE AS OF CHANGE: 20210622
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: RAVICH MARK H
CENTRAL INDEX KEY: 0000897727
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23661
FILM NUMBER: 211036386
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ROCKWELL MEDICAL, INC.
CENTRAL INDEX KEY: 0001041024
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 383317208
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 30142 WIXOM ROAD
CITY: WIXOM
STATE: MI
ZIP: 48393
BUSINESS PHONE: 8004493353
MAIL ADDRESS:
STREET 1: 30142 WIXOM ROAD
CITY: WIXOM
STATE: MI
ZIP: 48393
FORMER COMPANY:
FORMER CONFORMED NAME: ROCKWELL MEDICAL TECHNOLOGIES INC
DATE OF NAME CHANGE: 20120530
FORMER COMPANY:
FORMER CONFORMED NAME: ROCKWELL MEDICAL, INC.
DATE OF NAME CHANGE: 20120525
FORMER COMPANY:
FORMER CONFORMED NAME: ROCKWELL MEDICAL TECHNOLOGIES INC
DATE OF NAME CHANGE: 19970722
4
1
wf-form4_162439722360264.xml
FORM 4
X0306
4
2021-06-17
0
0001041024
ROCKWELL MEDICAL, INC.
RMTI
0000897727
RAVICH MARK H
C/O ROCKWELL MEDICAL, INC.
30142 WIXOM ROAD
WIXOM
MI
48393
1
0
0
0
Common Stock
2021-06-17
4
A
0
50000
0
A
253604
D
Common Stock
16000
I
By: Alyssa Danielle Ravich 1991 Irrevocable Trust
Common Stock
9000
I
By: Alexander Coleman Ravich 1991 Irrevocable Trust
Common Stock
219905
I
BY: Revocable Trust of Mark H Ravich
Stock Option (Right to Buy)
0.9
2021-06-17
4
A
0
72857
0
A
2031-06-17
Common Stock
72857.0
72857
D
Restricted stock units vest on June 17, 2022, subject to the Reporting Person's continued service to the Issuer.
Represents securities owned directly by Alyssa Danielle Ravich 1991 Irrevocable Trust ("ADR Trust"). Mr. Ravich, as the trustee of ADR Trust, may be deemed to beneficially own the securities owned directly by ADR Trust.
Represents securities owned directly by Alexander Coleman Ravich 1991 Irrevocable Trust ("ACR Trust"). Mr. Ravich, as the trustee of ACR Trust, may be deemed to beneficially own the securities owned directly by ACR Trust.
Represents securities owned directly by Revocable Trust of Mark H Ravich ("MHR Trust"). Mr. Ravich, as the trustee of MHR Trust, may be deemed to beneficially own the securities owned directly by MHR Trust.
Stock options shall vest in accordance with the following vesting schedule: (1) one-half (fifty percent) of the shares of Common Stock subject to this Option shall vest on June 17, 2023; and (2) the final one-half (remaining fifty percent) of the shares of Common Stock subject to this Option shall vest on June 17, 2025, subject to the Reporting Person's continued service to the Issuer.
/s/ Michael G. Costello, Attorney-in-Fact for Mark H. Ravich
2021-06-22