0001104659-20-105238.txt : 20200915 0001104659-20-105238.hdr.sgml : 20200915 20200915161802 ACCESSION NUMBER: 0001104659-20-105238 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200911 FILED AS OF DATE: 20200915 DATE AS OF CHANGE: 20200915 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MARIO ERNEST CENTRAL INDEX KEY: 0001180469 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38365 FILM NUMBER: 201176195 MAIL ADDRESS: STREET 1: 20 FAIRMOUNT AVENUE STREET 2: P.O. BOX 445 CITY: CHATHAM STATE: NJ ZIP: 07928 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: EYENOVIA, INC. CENTRAL INDEX KEY: 0001682639 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 471178401 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 295 MADISON AVENUE, STREET 2: SUITE 2400 CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 813-766-9539 MAIL ADDRESS: STREET 1: 295 MADISON AVENUE, STREET 2: SUITE 2400 CITY: NEW YORK STATE: NY ZIP: 10017 4 1 tm2030853d6_4.xml OWNERSHIP DOCUMENT X0306 4 2020-09-11 0 0001682639 EYENOVIA, INC. EYEN 0001180469 MARIO ERNEST C/O EYENOVIA, INC. 295 MADISON AVENUE, SUITE 2400 NEW YORK NY 10017 1 0 0 0 Common Stock, par value $.0001 2020-09-11 4 A 0 7288 0.00 A 334527 D Stock Option (right to buy) 3.43 2020-09-11 4 A 0 9820 0.00 A 2030-09-11 Common Stock 9820 9820 D Class A Warrant 2.27 2020-03-24 2021-03-24 Common Stock 41216 41216 D Class B Warrant 2.724 2020-03-24 2025-03-24 Common Stock 61823 61823 D Stock Option (right to buy) 1.24 2015-03-23 2025-03-23 Common Stock 40000 40000 D Stock Option (right to buy) 1.95 2027-07-07 Common Stock 33334 33334 D Stock Option (right to buy) 6.2 2028-07-24 Common Stock 4465 4465 D Stock Option (right to buy) 3.11 2029-08-16 Common Stock 9057 9057 D Represents restricted stock units that vest on the earlier of September 11, 2021 or the date of the Issuer's 2021 annual meeting of stockholders, subject to the Reporting Person's continued service on the Issuer's Board of Directors and acceleration upon change in control. The option becomes exercisable on the earlier of September 11, 2021 or the date of the Issuer's 2021 annual meeting of stockholders, subject to the Reporting Person's continued service on the Issuer's Board of Directors and acceleration upon change in control. On March 24, 2020, the Reporting Person purchased Units from the Issuer in a private placement, with each Unit consisting of (a) one share of the Issuer's common stock, (b) a Class A Warrant representing the right to acquire 0.5 shares of the Issuer's common stock and (c) a Class B Warrant representing the right to acquire 0.75 shares of the Issuer's common stock. The purchase price for each Unit was $2.42625 of which $2.27 was for the share of the Issuer's common stock, $0.06250 was for the Class A Warrant and $0.09375 was for the Class B Warrant. The exercise price per share of the Issuer's common stock issuable upon exercise of the Class A and Class B Warrants is subject to adjustment for stock splits, stock dividends and similar corporate events. The number of shares of Issuer common stock issuable upon exercise of the Class A and Class B Warrants is subject to adjustment for stock splits, stock dividends and similar corporate events. The option is fully vested. /s/ S. Halle Vakani, Attorney-in-Fact 2020-09-15