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