0000914190-17-000393.txt : 20171222 0000914190-17-000393.hdr.sgml : 20171222 20171222113456 ACCESSION NUMBER: 0000914190-17-000393 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171220 FILED AS OF DATE: 20171222 DATE AS OF CHANGE: 20171222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PERSEN MALCOLM C CENTRAL INDEX KEY: 0001287975 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32288 FILM NUMBER: 171271741 MAIL ADDRESS: STREET 1: NEPHROS, INC. STREET 2: 41 GRAND AVE. CITY: RIVER EDGE STATE: NJ ZIP: 07661 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NEPHROS INC CENTRAL INDEX KEY: 0001196298 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 133971809 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 380 LACKAWANNA PLACE CITY: SOUTH ORANGE STATE: NJ ZIP: 07079 BUSINESS PHONE: 201.343.5202 MAIL ADDRESS: STREET 1: 380 LACKAWANNA PLACE CITY: SOUTH ORANGE STATE: NJ ZIP: 07079 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2017-12-20 0001196298 NEPHROS INC NEPH 0001287975 PERSEN MALCOLM C C/O NEPHROS, INC. 380 LACKAWANNA PLACE SOUTH ORANGE NJ 07079 1 0 0 0 Common Stock 2017-12-20 4 A 0 113636 0 A 265241 D Common Stock 31160 I By spouse Warrants (right to buy) .85 2015-05-12 2020-05-18 Common Stock 15580 15580 I By spouse Stock Option (Right to Buy) .79 2025-05-07 Common Stock 56981 56981 D Stock Option (Right to Buy) .40 2026-08-24 Common Stock 33880 33880 D Stock Option (Right to Buy) .4999 2017-12-20 4 A 0 40284 0 A 2027-12-20 Common Stock 40284 40284 D On December 20, 2017, the Company granted 113,636 shares of restricted stock of the Company (the "Restricted Stock") in lieu of cash fees payable to Mr. Persen in respect of his services as a member of the Board of Directors of the Company. The Restricted Stock was granted under the Company's 2015 Equity Incentive Plan (the "2015 Plan"). The Restricted Stock vests 6 months following the grant date. Fully exercisable. The option vests as to 11,294 shares on 8/24/16 and as to 11,293 shares on each of 8/24/17 and 8/24/18. On December 20, 2017, the Company granted an option to purchase 40,284 shares of common stock of the Company (the "Option") in respect of the service by Mr. Persen as a member of the Board of Directors of the Company. The Option was granted under the 2015 Plan. The Option vests as to 13,428 shares on each of 12/20/17, 12/20/18 and 12/20/19. /s/ Amanda Lorentz as attorney-in-fact for Malcolm Persen pursuant to power of attorney previously filed. 2017-12-22