Sec Form 4 Filing - TELLEZ CORA M @ CorMedix Inc. - 2016-11-30

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
TELLEZ CORA M
2. Issuer Name and Ticker or Trading Symbol
CorMedix Inc. [ CRMD]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O CORMEDIX INC., 1430 HIGHWAY 206, SUITE 200
3. Date of Earliest Transaction (MM/DD/YY)
11/30/2016
(Street)
BEDMINSTER, NJ07921
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
Common Stock 11/30/2016 P 1,800 ( 1 ) A $ 1.8 112,761 D
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
Phantom Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 4,143 4,14 3 D
Stock Option (Right to buy Common Stock) $ 2.05 ( 3 ) 04/03/2024 Common Stock 30,000 30,000 D
Stock Option (Right to buy Common Stock) $ 5.62 ( 4 ) 03/01/2025 Common Stock 50,000 50,000 D
Phantom Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 4,205 4,205 D
Phantom Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 2,873 2,873 D
Phantom Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 1,371 1,371 D
Phantom Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 2,868 2,868 D
Phantom Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 3,645 3,645 D
Stock Option (Right to buy Common Stock) $ 1.91 ( 4 ) 02/21/2026 Common Stock 100,000 100,000 D
Phantom Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 4,104 4,104 D
Phantom Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 2,767 2,767 D
Phantom Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 4,335 4,335 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
TELLEZ CORA M
C/O CORMEDIX INC.
1430 HIGHWAY 206, SUITE 200
BEDMINSTER, NJ07921
X
Signatures
/s/ Alexander M. Donaldson, by Power of Attorney 12/02/2016
Signature of Reporting Person Date
Explanation of Responses:
( 1 )This purchase was effected pursuant to a Rule 10b5-1 trading plan executed by the reporting person on August 19, 2016.
( 2 )Each share of phantom stock is the economic equivalent of one share of common stock. The shares of phantom stock become payable in common stock on the tenth business day of January of the year following the reporting person's termination of service as a director.
( 3 )The options vest 1/3 on the date of grant, 1/3 on the first anniversary of the date of grant, and 1/3 on the second anniversary of the date of grant.
( 4 )The options vest in full on the first anniversary of the date of grant.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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