0001493152-17-012787.txt : 20171113 0001493152-17-012787.hdr.sgml : 20171110 20171113063909 ACCESSION NUMBER: 0001493152-17-012787 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171110 FILED AS OF DATE: 20171113 DATE AS OF CHANGE: 20171113 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mogford Jon CENTRAL INDEX KEY: 0001691078 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-51128 FILM NUMBER: 171192928 MAIL ADDRESS: STREET 1: C/O MEDOVEX CORP STREET 2: 3279 HARDEE AVENUE CITY: ATLANTA STATE: GA ZIP: 30341 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: POLARITYTE, INC. CENTRAL INDEX KEY: 0001076682 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 061529524 STATE OF INCORPORATION: DE FISCAL YEAR END: 1031 BUSINESS ADDRESS: STREET 1: 615 ARAPEEN DRIVE CITY: SALT LAKE CITY STATE: UT ZIP: 84108 BUSINESS PHONE: (385) 237-2279 MAIL ADDRESS: STREET 1: 615 ARAPEEN DRIVE CITY: SALT LAKE CITY STATE: UT ZIP: 84108 FORMER COMPANY: FORMER CONFORMED NAME: MAJESCO ENTERTAINMENT CO DATE OF NAME CHANGE: 20050427 FORMER COMPANY: FORMER CONFORMED NAME: MAJESCO HOLDINGS INC DATE OF NAME CHANGE: 20040416 FORMER COMPANY: FORMER CONFORMED NAME: CONNECTIVCORP DATE OF NAME CHANGE: 20010815 4 1 form4.xml X0306 4 2017-11-10 0 0001076682 POLARITYTE, INC. COOL 0001691078 Mogford Jon C/O POLARITYTE, INC 615 ARAPEEN DRIVE SALT LAKE CITY UT 84108 1 0 0 0 Common stock, par value $0.001 per share 2017-11-10 4 A 0 5000 0.00 A 23333 D Option 24.59 2017-11-10 4 A 0 5000 0.00 A 2027-11-10 Common Stock 5000 416 D Represents a restricted stock award under the PolarityTE, Inc. 2017 Equity Incentive Plan (the "Restricted Stock Award"), which shall vest in twenty four (24) equal monthly installments on the one month anniversary of the grant date. Restricted Stock Award is issued as a performance award for the Reporting Person's service as a director of the Issuer. Includes shares vested or to be vested within 60 days pursuant to the Restricted Stock Award. Represents an option award under the PolarityTE, Inc. 2017 Equity Incentive Plan (the "Option Award"), which shall vest in twenty four (24) equal monthly installments on the one month anniversary of the grant date. Option Award is issued as a performance award for the Reporting Person's service as a director of the Issuer. Includes options vested or to be vested within 60 days pursuant to the Option Award. /s/ Jon Mogford 2017-11-13