0001628280-19-001778.txt : 20190222 0001628280-19-001778.hdr.sgml : 20190222 20190222170405 ACCESSION NUMBER: 0001628280-19-001778 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190219 FILED AS OF DATE: 20190222 DATE AS OF CHANGE: 20190222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KLEMP WALTER V CENTRAL INDEX KEY: 0000938419 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38815 FILM NUMBER: 19626544 MAIL ADDRESS: STREET 1: 1415 WEST LOOP NORTH CITY: HOUSTON STATE: TX ZIP: 77055 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Soliton, Inc. CENTRAL INDEX KEY: 0001548187 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 364729076 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1225 NORTH LOOP WEST, STE. 725 CITY: HOUSTON STATE: TX ZIP: 77008 BUSINESS PHONE: 713-305-5041 MAIL ADDRESS: STREET 1: 1225 NORTH LOOP WEST, STE. 725 CITY: HOUSTON STATE: TX ZIP: 77008 3 1 wf-form3_155087302532393.xml FORM 3 X0206 3 2019-02-19 0 0001548187 Soliton, Inc. SOLY 0000938419 KLEMP WALTER V C/O SOLITON, INC. 5304 ASHBROOK DRIVE HOUSTON TX 77081 1 0 0 0 Common Stock 425000 D Option to purchase common stock (right to buy) 1.75 2028-06-18 Common Stock 725000.0 D Option to purchase common stock (right to buy) 1.75 2029-02-05 Common Stock 84500.0 D Warrant to purchase common stock (right to buy) 1.75 2018-10-19 2023-10-19 Common Stock 11512.0 D Warrant to purchase common stock (right to buy) 1.75 2018-10-30 2023-10-30 Common Stock 8634.0 D Warrant to purchase common stock (right to buy) 1.75 2018-11-15 2023-11-15 Common Stock 7771.0 D The options set forth in this table vest in four equal annual installments beginning on the first anniversary of the issuance date, or June 18, 2018, subject to the grantee's continued service on each vesting date. The options set forth in this table vest in four equal quarterly installments beginning on the issuance date, or February 5, 2019, subject to the grantee's continued service on each vesting date. /s/ Walter Klemp 2019-02-19