Statement of Changes in Beneficial Ownership (4)
September 24 2021 - 3:08PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
*
MYERS ROBERT L |
2. Issuer Name and Ticker or Trading Symbol
Predictive Oncology Inc.
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POAI
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chief Financial Officer |
(Last)
(First)
(Middle)
2915 COMMERS DRIVE, SUITE 900 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
9/23/2021 |
(Street)
EAGAN, MN 55121
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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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)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock, $.01 par value | 9/23/2021 | | M(2) | | 33334 | A | $1.13 (1) | 33411 | D | |
Common Stock, $.01 par value | 9/23/2021 | | D(3) | | 10200 | D | $1.13 | 23211 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Restricted Stock Units | (1) | 9/23/2021 | | M | | | 33334 | (2) | (1)(2) | Common Stock | 33334 | $0 | 66666 | D | |
Explanation of Responses: |
(1) | Each Restricted Stock Unit (RSU) represents a contingent right to receive one share of common stock. The shares are delivered to the Reporting Person upon vesting. |
(2) | On September 23, 2020, the reporting person was granted 100,000 restricted stock units, vesting in three annual installments beginning on the first anniversary of the grant date. The first of these installments vests on September 23, 2021. The remainder vests on each of 9/23/2022 and 9/23/2023. |
(3) | 10,200 shares of common stock forfeited to Company on September 23, 2021 to cover withholding tax, in accordance with Restricted Stock Unit Agreement between Reporting Person and Company. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
MYERS ROBERT L 2915 COMMERS DRIVE, SUITE 900 EAGAN, MN 55121 |
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| Chief Financial Officer |
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Signatures
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/s/ Bob Myers | | 9/24/2021 |
**Signature of Reporting Person | Date |
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