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*
Simpson John D.

(Last) (First) (Middle)
400 CHESAPEAKE DRIVE

(Street)
REDWOOD CITY CA 94063

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/12/2016
3. Issuer Name and Ticker or Trading Symbol
Avinger Inc [ AVGR ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Sr. VP, Sales & Marketing
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 stock 37,037 I John David Simpson Trustee of Simpson Trust Dated 12/9/08
Common stock 5,036 I John David Simpson Trustee of Simpson Trust Dated 12/9/08
Common stock 76,490 I John David Simpson Trustee of Simpson Trust Dated 12/9/08
Common stock 30,974 I John David Simpson Trustee of Simpson Trust Dated 12/9/08
Common stock 39,681 I John David Simpson Trustee of Simpson Trust Dated 12/9/08
Common stock 62,379 I John David Simpson Trustee of Simpson Trust Dated 12/9/08
Common stock 986 I John David Simpson Trustee of Simpson Trust Dated 12/9/08
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
Option (right to buy) 12/31/2014 12/31/2024 Common Stock 22,222 $4.5 D
Option (right to buy) 12/31/2014 12/31/2024 Common Stock 36,161 $4.5 D
Option (right to buy) 03/09/2010 03/09/2020 Common Stock 5,747 $4.95 D
Option (right to buy) 06/16/2010 07/01/2020 Common Stock 4,738 $4.95 D
Option (right to buy) 07/29/2011 07/29/2021 Common Stock 952 $12.6 D
Option (right to buy) 07/29/2011 07/29/2021 Common Stock 7,936 $12.6 D
Option (right to buy) 05/01/2013 05/01/2023 Common Stock 4,938 $20.25 D
Option (right to buy) 05/01/2013 05/01/2023 Common Stock 10,211 $20.25 D
Stock Option (Right to Buy) 03/03/2017(1) 03/03/2026 Stock Option (Right to Buy) 15,000 $12.99 D
Restricted Stock Units 03/03/2017 (3) Common stock 7,500(4) (2) D
Warrants 09/02/2014 09/02/2016 Common stock 27,777 $12.6 I John David Simpson Trustee of Simpson Trust dated 12/9/08
Explanation of Responses:
1. The stock options vest 25% on the first anniversary of the transaction date and monthly thereafter in 36 equal increments.
2. No exercise price for this type of award
3. No expiration date for this type of award
4. Reporting person received a grant under the 2015 Plan of RSUs with a grant date fair value of $12.99 per share. The RSUs vest annually over four years in equal increments.
Remarks:
/s/ John D Simpson 07/22/2016
** 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.