FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL 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 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
Form 3 Holdings Reported. | |||||||||||||||||
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Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
REVA Medical, Inc. [ RVA:AX ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 12/31/2018 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||||||||
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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 at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
Amount | (A) or (D) | Price | |||||||||||||
Common Stock, par value $0.0001 per share | 06/29/2018 | P4 | 220,000 | A | (6) | 12,453,969 | I | See footnotes(1)(2)(3)(4)(5) | |||||||
Common Stock, par value $0.0001 per share | 06/29/2018 | P4 | 17,600 | A | (6) | 12,453,969 | I | See footnotes(1)(2)(3)(4)(5) | |||||||
Common Stock, par value $0.0001 per share | 06/29/2018 | P4 | 22,400 | A | (6) | 12,453,969 | I | See footnotes(1)(2)(3)(4)(5) | |||||||
Common Stock, par value $0.0001 per share | 07/16/2018 | S4 | 134,489 | D | (6) | 12,453,969 | I | See footnotes(1)(2)(3)(4)(5) | |||||||
Common Stock, par value $0.0001 per share | 07/20/2018 | S4 | 125,511 | D | (6) | 12,453,969 | I | See footnotes(1)(2)(3)(4)(5) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||
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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) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. Senrigan Capital Management Limited, a Cayman Islands limited company ("SCM") with a business address of PO Box 309,Ugland House, Grand Cayman, KY-1104, is filing this Form 5 jointly with Senrigan Capital Group Limited, a Hong Kong limited company ("SCG"), and Nick Taylor, a citizen of the United Kingdom each of whom has a business address of 11th Floor, LHT Tower, 31 Queens Road Central, Hong Kong and may be deemed to have a pecuniary interest in securities reported by it on this Form 5 ("the Subject Securities"). Collectively, these are the "Reporting Persons." |
2. SCM advises the accounts of the Senrigan Master Fund Limited, a Cayman Islands limited company, Senrigan US Feeder Fund Limited, a Cayman Islands limited company, and Senrigan Fund Limited, a Cayman Islands limited company (together with Senrigan Master Fund Limited and Senrigan US Feeder Fund Limited, the "Senrigan Funds"). |
3. SCM, as the investment manager to the Senrigan Funds, may be deemed to be the beneficial owner of the Subject Securities for purposes of Rule 16a-1(a) of the Securities Exchange Act of 1934. Pursuant to an investment advisory agreement between SCM and SCG, SCG may be deemed to be the beneficial owner of the Subject Securities for purposes of Rule 16a-1(a). By virtue of Nick Taylor's position as majority owner of SCM, Nick Taylor may be deemed to be the beneficial owner of the Subject Securities for purposes of Rule 16a-1(a). |
4. Each of the Reporting Persons disclaims any beneficial ownership of any of the Subject Securities, except to the extent of any pecuniary interest therein. |
5. On June 29, 2018, the Reporting Persons purchased on the open market 2,600,000 CHESS Depository Instruments ("CDI") in Australia, of which US Common Sock underlies at a 1:10 ratio. These purchases were made to facilitate invidual purchases, including the following: Stephen N. Osterle, Brandi Roberts, Robert Bernard Stockman, Raymond C. Larkin Jr., Regina Groves, Richard M Kimes, and Robert Bain Thomas ("Company Insiders"), not to be held for the account of the Reporting Persons. Please see the relevant Form 4 filings made by the Company Insiders for June 29, 2018. These facilitating transactions were completed on 16 July 2018 and 20 July 2018 respectively, leaving the Reporting Persons flat, with no additional common stock acquired. |
6. Consideration was paid jointly by the Reporting Persons for the 2,600,000 CDI for a total compensation of USD $ 399,054. The total consideration paid to the Reporting Persons on 16 July was USD $204,544. The total consideration paid to the Reporting Persons on 20 July was USD $ 192,548. This led to a net loss of USD $1,962 with regard to the facilitation transaction made on behalf of the Company Insiders. |
Senrigan Capital Management Limited By: /s/ Nick Taylor Name: Nick Taylor Title: Director | 02/14/2019 | |
Senrigan Capital Group Limited By: /s/ Chris Nash Name: Chris Nash Title: Chief Operating Officer | 02/14/2019 | |
/s/ Nick Taylor | 02/14/2019 | |
** 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. |