SEC Form 4
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
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
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*
Randolph Edward David

(Last) (First) (Middle)
12744 SAN FERNANDO ROAD
SUITE 400

(Street)
SYLMAR CA 91342

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
SECOND SIGHT MEDICAL PRODUCTS INC [ EYES ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Vice President of Manufacturin
3. Date of Earliest Transaction (Month/Day/Year)
01/03/2017
4. 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 Acquired, Disposed of, or Beneficially Owned
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
Common Stock 22(1) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Non-Qualified Stock Option (right to buy) $1.97 01/03/2017 A 151,170(2) 01/03/2018(3) 01/03/2027 Common Stock 151,170 (5) 151,170 D
Non-Qualified Stock Option (right to buy) $4.1 01/21/2017(3) 01/21/2026 Common Stock 11,513 11,513 D
Non-Qualified Stock Option (right to buy) $5 08/01/2008(4) 08/01/2017 Common Stock 50,000 50,000 D
Non-Qualified Stock Option (right to buy) $5 02/01/2009(4) 02/01/2018 Common Stock 2,290 2,290 D
Non-Qualified Stock Option (right to buy) $5 11/01/2009(4) 11/01/2018 Common Stock 25,000 25,000 D
Non-Qualified Stock Option (right to buy) $5 02/01/2010(4) 02/01/2019 Common Stock 6,750 6,750 D
Non-Qualified Stock Option (right to buy) $5 02/01/2011(4) 02/01/2020 Common Stock 20,750 20,750 D
Non-Qualified Stock Option (right to buy) $5 03/01/2012(4) 03/01/2021 Common Stock 8,313 8,313 D
Non-Qualified Stock Option (right to buy) $5 03/01/2013(4) 03/01/2022 Common Stock 7,750 7,750 D
Non-Qualified Stock Option (right to buy) $5 04/01/2015(4) 04/01/2024 Common Stock 10,937 10,937 D
Non-Qualified Stock Option (right to buy) $9 09/26/2015(4) 09/26/2024 Common Stock 65,895 65,895 D
Non-Qualified Stock Option (right to buy) $13.09 03/25/2016(4) 03/25/2025 Common Stock 6,250 6,250 D
Explanation of Responses:
1. 22 shares, acquired as part of scheduled ESSP purchases.
2. Options to purchase 151,170 shares of the Company's common stock were granted to Mr. Randolph under the Company's 2011 Equity Incentive Plan.
3. Options vest over a four year term of which one-fourth vests on the Date Exercisable, with the remaining options vesting quarterly over three years thereafter.
4. Options vest in 4 yearly increments starting with the Date Exercisable.
5. Not Applicable.
Edward Randolph 01/05/2017
** 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.