FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
GLOBUS MEDICAL INC [ GMED ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 09/03/2013 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Class A Common Stock | 09/03/2013 | J(1) | 7,244,201 | D | $0.00 | 0 | I | By L.P.(2) | ||
Class A Common Stock | 09/03/2013 | J(3) | 51,319 | A | $0.00 | 51,319 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option (Right to Buy Class A Common Stock) | $15.34 | (4) | 08/29/2022 | Class A Common Stock | 15,300 | 15,300 | D | ||||||||
Stock Option (Right to Buy Class A Common Stock) | $12.59 | (5) | 01/30/2023 | Class A Common Stock | 7,500 | 7,500 | D |
Explanation of Responses: |
1. Distribution of shares in kind by Clarus Lifesciences I, L.P. (the "Fund") to its partners. |
2. Clarus Ventures I Management, L.P. ("Clarus I Management") is the sole general partner of the Fund and Clarus Ventures I, LLC ("Clarus I GPLLC") is the sole general partner of Clarus I Management. Mr. Wheeler is a managing director of Clarus I GPLLC. As a managing director of Clarus I GPLLC, Mr. Wheeler has shared voting and disposition power related to these shares and disclaims beneficial ownership of these shares. |
3. Distribution of shares in kind by the Fund. In prior reports, the Reporting Person reported that he may be deemed to beneficially own shares held of record by the Fund. As a result of the distribution of shares in kind, the Reporting Person now holds the reported shares directly. |
4. These options vest over a three-year period with one-twelfth (1/12) of the options granted vesting on December 31, 2012, and the balance of the options granted vesting ratably on a quarterly basis over the following 11 quarters. |
5. These options were granted on January 30, 2013, and vest over a four-year period with one-fourth (1/4) of the options granted vesting on January 1, 2014, the first anniversary of the vesting commencement date, and the balance of the options granted vesting ratably on a monthly basis over the following 36 months. |
Remarks: |
/s/ David P. Creekman, Attorney-in-Fact | 09/05/2013 | |
** 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 4 (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. |