Sec Form 4 Filing - McKhann Chas @ Apollo Endosurgery, Inc. - 2021-03-10

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
McKhann Chas
2. Issuer Name and Ticker or Trading Symbol
Apollo Endosurgery, Inc. [ APEN]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
President and CEO
(Last) (First) (Middle)
1120 S. CAPITAL OF TEXAS HIGHWAY, BUILDING ONE, SUITE 300
3. Date of Earliest Transaction (MM/DD/YY)
03/10/2021
(Street)
AUSTIN, TX78746
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 03/10/2021( 1 ) A 707,278 A $ 0 707,278 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
Stock Option (Right to Buy) $ 5.95 03/10/2021( 2 ) A 848,733 ( 2 ) 03/10/2031 Common Stock 848,733 $ 5.95 848,733 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
McKhann Chas
1120 S. CAPITAL OF TEXAS HIGHWAY
BUILDING ONE, SUITE 300
AUSTIN, TX78746
X President and CEO
Signatures
/s/ Brian Szymczak - Attorney-in-Fact 03/12/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Represents the grant of Restricted Stock Units ("RSU"). Each RSU provides the Reporting Person with a contingent right to receive one share of the Issuer's common stock. One quarter of the RSU grant will vest upon the achievement of revenue for the trailing for the trailing four quarters equal to each of $50 million, $65 million, $80 million and $95 million, subject to the Reporting Person providing continuous service to the Issuer through each such date. Accelerated vesting may occur in the event of a Change in Control, as that term is defined in the Apollo Endosurgery, Inc. 2017 Equity Incentive Plan. The RSU grant, which was granted outside of the 2017 Equity Incentive Plan, was approved by the Issuer's Board of Directors and issued pursuant to the "inducement" grant exception under Listing Rule 5635(c)(4) of the Nasdaq Stock Market LLC. The RSU grant will be governed by the terms of the 2017 Equity Incentive Plan.
( 2 )The shares underlying the option will vest over a period of four years, with 25% of the shares vesting on the first anniversary of the grant date and the remainder will vest in equal monthly installments over the following three years, subject to the Reporting Person providing continuous service to the Issuer through each such date. Accelerated vesting may occur in the event of a Change in Control, as that term is defined in the Apollo Endosurgery, Inc. 2017 Equity Incentive Plan. The option, which was granted outside of the 2017 Equity Incentive Plan, was approved by the Issuer's Board of Directors and issued pursuant to the "inducement" grant exception under Listing Rule 5635(c)(4) of the Nasdaq Stock Market LLC. The option will be governed by the terms of the 2017 Equity Incentive Plan.

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).
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