0001628280-20-017292.txt : 20201209 0001628280-20-017292.hdr.sgml : 20201209 20201209165855 ACCESSION NUMBER: 0001628280-20-017292 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201207 FILED AS OF DATE: 20201209 DATE AS OF CHANGE: 20201209 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: 201378412 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ROCKWELL MEDICAL, INC. CENTRAL INDEX KEY: 0001041024 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 383317208 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 30142 WIXOM ROAD CITY: WIXOM STATE: MI ZIP: 48393 BUSINESS PHONE: 8004493353 MAIL ADDRESS: STREET 1: 30142 WIXOM ROAD 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 4 1 wf-form4_160755112113783.xml FORM 4 X0306 4 2020-12-07 0 0001041024 ROCKWELL MEDICAL, INC. RMTI 0000897727 RAVICH MARK H C/O ROCKWELL MEDICAL, INC. 411 HACKENSACK AVENUE, SUITE 501 HACKENSACK NJ 07601 1 0 0 0 Common Stock 2020-12-07 4 J 0 219905 1.224 D 0 I By: Cindy Libman Irrevocable Trust Common Stock 2020-12-07 4 J 0 219905 1.224 A 219905 I BY: Revocable Trust of Mark H Ravich Common Stock 203604 D Common Stock 9000 I By: Alexander Coleman Ravich 1991 Irrevocable Trust Common Stock 16000 I By: Alyssa Danielle Ravich 1991 Irrevocable Trust Represents the transfer of shares of common stock from Cindy Libman Irrevocable Trust ("CL Trust") to Revocable Trust of Mark H Ravich ("MHR Trust"). The Reporting Person is the trustee of each of the CL Trust and the MHR Trust. The Reporting Person's total beneficial ownership in the Issuer has not changed, as he was the beneficial owner of these shares both before and after the transfer reported herein. Represents securities owned directly by CL Trust. Mr. Ravich, as the trustee of CL Trust, may be deemed to beneficially own the securities owned directly by CL Trust. Represents securities owned directly by Revocable Trust of Mark H Ravich ("MHR Trust"). Mr. Ravich, as the trustee of MHR Trust, may be deemed to beneficially own the securities owned directly by MHR Trust. Includes 30,800 shares of common stock underlying unvested restricted stock units that vest based on the achievement of certain time-based milestones. Represents securities owned directly by Alexander Coleman Ravich 1991 Irrevocable Trust ("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 Alyssa Danielle Ravich 1991 Irrevocable Trust ("ADR Trust"). Mr. Ravich, as the trustee of ADR Trust, may be deemed to beneficially own the securities owned directly by ADR Trust. /s/ Michael G. Costello, Attorney-in-Fact for Mark H. Ravich 2020-12-09