SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
Machan Warren J

(Last) (First) (Middle)
5405 WINDWARD PKWY

(Street)
ALPHARETTA GA 30004

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/28/2024
3. Issuer Name and Ticker or Trading Symbol
AVANOS MEDICAL, INC. [ AVNS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Interim CFO
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 9,351 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Options (right to buy) (1) 11/07/2024 Common Stock 1,600 $37.88 D
Employee Stock Options (right to buy) (2) 03/05/2025 Common Stock 4,994 $45.47 D
Employee Stock Options (right to buy) (3) 05/05/2025 Common Stock 5,609 $45.53 D
Employee Stock Options (right to buy) (4) 04/01/2026 Common Stock 9,870 $29.48 D
Employee Stock Option (right to buy) (5) 04/01/2026 Common Stock 8,979 $36.74 D
Employee Stock Option (right to buy) (6) 04/01/2026 Common Stock 7,305 $52.1 D
Employee Stock Options (right to buy) (7) 04/01/2026 Common Stock 16,379 $43.59 D
Employee Stock Option (right to buy) (8) 04/01/2026 Common Stock 10,501 $28.87 D
Explanation of Responses:
1. These options vested 30% on November 7, 2015, 30% on November 7, 2016, and 40% on November 7, 2017.
2. These options vested 1/3 on each of March 5, 2018, March 5, 2019 and March 5, 2020.
3. These options vested 30% on May 5, 2016, 30% on May 5, 2017, and 40% on May 5, 2018.
4. These options vested 30% on May 5, 2017, 30% on May 5, 2018, and 40% on May 5, 2019.
5. These ooptions vested 30% on May 3, 2018, 30% on May 3, 2019, and 40% on May 3, 2020.
6. These options vested 30% on May 8, 2019, 30% on May 8, 2020, and 40% on May 8, 2021.
7. These options vested 30% on May 8, 2020, 30% on May 8, 2021, and 40% on May 8, 2022.
8. These options vested 30% on May 7, 2021, 30% on May 7, 2022 and 40% on May 7, 2023.
Remarks:
The reporting person first became subject to Section 16 as an officer of the Issuer on October 31, 2014; ceased to be subject to Section 16 in 2018; again became subject to Section 16 in 2019; ceased to be subject to Section 16 in 2020; and retired effective April 1, 2021. The reporting person became a Section 16 officer again on October 28, 2024 and therefore is filing this Form 3.
/s/ Mojirade James, as attorney-in-fact for Warren J. Machan pursuant to power of attorney filed herewith 11/06/2024
** 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 5 (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.