Sec Form 4 Filing - Smith David E @ CATASYS, INC. - 2016-12-29

Insider filing report for Changes in Beneficial Ownership
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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
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Smith David E
2. Issuer Name and Ticker or Trading Symbol
CATASYS, INC. [ CATS:OTC]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O COAST ASSET MANAGEMENT, LLC, 11150 SANTA MONICA BOULEVARD, SUITE 1400
3. Date of Earliest Transaction (MM/DD/YY)
12/29/2016
(Street)
LOS ANGELES, CA90025
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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
Warrant $ 0.85 12/29/2016 J( 1 ) 264,706 12/29/2016 12/29/2021 Common Stock 264,706 ( 1 ) 264,706 I Through Shamus, LLC
Convertible Debenture $ 0.85 12/29/2016 J( 2 ) 352,942 12/29/2016 03/31/2017 Common Stock 352,942 ( 2 ) 352,942 I Through Shamus, LLC
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Smith David E
C/O COAST ASSET MANAGEMENT, LLC
11150 SANTA MONICA BOULEVARD, SUITE 1400
LOS ANGELES, CA90025
X X
Signatures
/s/ David Smith 01/04/2017
Signature of Reporting Person Date
Explanation of Responses:
( 1 )On December 29, 2016, Catasys, Inc. ("Catasys") issued to Shamus, LLC ("Shamus") a warrant exercisable for 264,706 shares of Catasys common stock at the exercise price of $0.85 per share (the "Warrant"), subject to potential future adjustment pursuant to the provisions of the Warrant. The Warrant was issued to Shamus concurrently and in connection with a debt financing from Shamus to Catasys pursuant to an 8% Series B convertible debenture dated as of December 29, 2016 (the "Debenture").
( 2 )On December 29, 2016, Catasys issued the Debenture to Shamus. At the option of the holder, the Debenture is convertible into 352,942 shares of Catasys common stock at the conversion price of $0.85 per share, subject to potential future adjustment pursuant to the provisions of the Debenture.

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