0000921895-17-001617.txt : 20170523 0000921895-17-001617.hdr.sgml : 20170523 20170523175037 ACCESSION NUMBER: 0000921895-17-001617 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170519 FILED AS OF DATE: 20170523 DATE AS OF CHANGE: 20170523 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ROCKWELL MEDICAL, INC. CENTRAL INDEX KEY: 0001041024 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 383317208 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 30142 S WIXOM RD CITY: WIXOM STATE: MI ZIP: 48393 BUSINESS PHONE: 2489609009 MAIL ADDRESS: STREET 1: 30142 S WIXOM RD CITY: WIXOM STATE: MI ZIP: 48393 FORMER COMPANY: FORMER CONFORMED NAME: ROCKWELL MEDICAL TECHNOLOGIES INC DATE OF NAME CHANGE: 20120530 FORMER COMPANY: FORMER CONFORMED NAME: ROCKWELL MEDICAL, INC. DATE OF NAME CHANGE: 20120525 FORMER COMPANY: FORMER CONFORMED NAME: ROCKWELL MEDICAL TECHNOLOGIES INC DATE OF NAME CHANGE: 19970722 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Alyssa Danielle Ravich 1991 Irrevocable Trust CENTRAL INDEX KEY: 0001698590 STATE OF INCORPORATION: MN FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23661 FILM NUMBER: 17864876 BUSINESS ADDRESS: STREET 1: 600 SOUTH HIGHWAY 169 STREET 2: SUITE 1660 CITY: ST. LOUIS PARK STATE: MN ZIP: 55426 BUSINESS PHONE: 763-923-7886 MAIL ADDRESS: STREET 1: 600 SOUTH HIGHWAY 169 STREET 2: SUITE 1660 CITY: ST. LOUIS PARK STATE: MN ZIP: 55426 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Alexander Coleman Ravich 1991 Irrevocable Trust CENTRAL INDEX KEY: 0001698545 STATE OF INCORPORATION: MN FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23661 FILM NUMBER: 17864877 BUSINESS ADDRESS: STREET 1: 600 SOUTH HIGHWAY 169 STREET 2: SUITE 1660 CITY: ST. LOUIS PARK STATE: MN ZIP: 55426 BUSINESS PHONE: 763-923-7886 MAIL ADDRESS: STREET 1: 600 SOUTH HIGHWAY 169 STREET 2: SUITE 1660 CITY: ST. LOUIS PARK STATE: MN ZIP: 55426 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Norman & Sally Ravich Family Trust CENTRAL INDEX KEY: 0001698591 STATE OF INCORPORATION: MN FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23661 FILM NUMBER: 17864878 BUSINESS ADDRESS: STREET 1: 600 SOUTH HIGHWAY 169 STREET 2: SUITE 1660 CITY: ST. LOUIS PARK STATE: MN ZIP: 55426 BUSINESS PHONE: 763-923-7886 MAIL ADDRESS: STREET 1: 600 SOUTH HIGHWAY 169 STREET 2: SUITE 1660 CITY: ST. LOUIS PARK STATE: MN ZIP: 55426 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Norman J. Ravich Irrevocable Trust CENTRAL INDEX KEY: 0001698580 STATE OF INCORPORATION: MN FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23661 FILM NUMBER: 17864879 BUSINESS ADDRESS: STREET 1: 600 SOUTH HIGHWAY 169 STREET 2: SUITE 1660 CITY: ST. LOUIS PARK STATE: MN ZIP: 55426 BUSINESS PHONE: 763-923-7886 MAIL ADDRESS: STREET 1: 600 SOUTH HIGHWAY 169 STREET 2: SUITE 1660 CITY: ST. LOUIS PARK STATE: MN ZIP: 55426 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RAVICH MARK H CENTRAL INDEX KEY: 0000897727 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23661 FILM NUMBER: 17864880 4 1 form411265002_05232017.xml OWNERSHIP DOCUMENT X0306 4 2017-05-19 0 0001041024 ROCKWELL MEDICAL, INC. RMTI 0000897727 RAVICH MARK H 600 SOUTH HIGHWAY 169 SUITE 1660 ST. LOUIS PARK MN 55426 0 0 0 1 See Footnote 1 0001698580 Norman J. Ravich Irrevocable Trust 600 SOUTH HIGHWAY 169 SUITE 1660 ST. LOUIS PARK MN 55426 0 0 0 1 See Footnote 1 0001698591 Norman & Sally Ravich Family Trust 600 SOUTH HIGHWAY 169 SUITE 1660 ST. LOUIS PARK MN 55426 0 0 0 1 See Footnote 1 0001698545 Alexander Coleman Ravich 1991 Irrevocable Trust 600 SOUTH HIGHWAY 169 SUITE 1660 ST. LOUIS PARK MN 55426 0 0 0 1 See Footnote 1 0001698590 Alyssa Danielle Ravich 1991 Irrevocable Trust 600 SOUTH HIGHWAY 169 SUITE 1660 ST. LOUIS PARK MN 55426 0 0 0 1 See Footnote 1 Common Stock 2017-05-19 4 X 0 30000 6.00 A 314750 D Common Stock 2017-05-19 4 X 0 10000 6.00 A 10000 I By: Norman and Sally Ravich Family Trust Common Stock 44400 I By: Norman J. Ravich Irrevocable Trust Common Stock 25000 I By: Alexander Coleman Ravich 1991 Irrevocable Trust Common Stock 25000 I By: Alyssa Danielle Ravich 1991 Irrevocable Trust Call Option (right to buy) 6.00 2017-05-19 4 X 0 300 0 D 2017-05-19 Common Stock 30000 0 D Call Option (right to buy) 6.00 2017-05-19 4 X 0 100 0 D 2017-05-19 Common Stock 10000 0 I By: Norman and Sally Ravich Family Trust This Form 4 is filed jointly by Norman J. Ravich Irrevocable Trust ("NJR Trust"), Norman and Sally Ravich Family Trust ("NSR Trust"), Alexander Coleman Ravich 1991 Irrevocable Trust ("ACR Trust"), Alyssa Danielle Ravich 1991 Irrevocable Trust ("ADR Trust") and Mark H. Ravich (collectively, the "Reporting Persons"). Each of the Reporting Persons may be deemed to be a member of a Section 13(d) group that may be deemed to collectively beneficially own more than 10% of the Issuer's outstanding shares of Common Stock. Each of the Reporting Persons disclaims beneficial ownership of the securities reported herein except to the extent of his or its pecuniary interest therein. The filing of this Form 4 shall not be deemed an admission that the Reporting Persons are, for purposes of Section 13(d) of the Securities Exchange Act of 1934, as amended, the beneficial owners of any securities of the Issuer he or it does not directly own. Represents securities owned directly by NJR Trust. Mr. Ravich, as the trustee of NJR Trust, may be deemed to beneficially own the securities owned directly by NJR Trust. Represents securities owned directly by ACR Trust. Mr. Ravich, as the trustee of ACR Trust, may be deemed to beneficially own the securities owned directly by ACR Trust. Represents securities owned directly by ADR Trust. Mr. Ravich, as the trustee of ADR Trust, may be deemed to beneficially own the securities owned directly by ADR Trust. Represents securities owned directly by NSR Trust. Mr. Ravich, as the trustee of NSR Trust, may be deemed to beneficially own the securities owned directly by NSR Trust. The Call Options reported herein were exercisable beginning on the date of their purchase. By: /s/ Mark H. Ravich 2017-05-23 By: Norman J. Ravich Irrevocable Trust, By: /s/ Mark H. Ravich, Trustee 2017-05-23 By: Norman and Sally Ravich Family Trust, By: /s/ Mark H. Ravich, Trustee 2017-05-23 By: Alexander Coleman Ravich 1991 Irrevocable Trust, By: /s/ Mark H. Ravich, Trustee 2017-05-23 By: Alyssa Danielle Ravich 1991 Irrevocable Trust, By: /s/ Mark H. Ravich, Trustee 2017-05-23