Sec Form 4 Filing - BLASKIE GERALD S @ SCI Engineered Materials, Inc. - 2021-11-02

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
BLASKIE GERALD S
2. Issuer Name and Ticker or Trading Symbol
SCI Engineered Materials, Inc. [ SCIA.OB]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
CFO AND VICE PRESIDENT
(Last) (First) (Middle)
1022 MCLEOD PARC
3. Date of Earliest Transaction (MM/DD/YY)
11/02/2021
(Street)
PICKERINGTON, OH43147
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, without par value 11/02/2021 M( 3 ) 2,492 A $ 1.25 33,525 D
Common stock, without par value 11/02/2021 F( 3 ) 605 ( 1 ) D $ 5.15 32,920 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 $ 1.25 11/02/2021 M 2,492 ( 2 ) ( 4 ) 05/15/2021 05/14/2028 Common Stock, without par value 2,492 $ 1.25 4,982 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
BLASKIE GERALD S
1022 MCLEOD PARC
PICKERINGTON, OH43147
CFO AND VICE PRESIDENT
Signatures
/s/ Gerald S Blaskie 11/03/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Reflects 605 shares withheld by the Issuer at the market price of $5.150 per share less an exercise price of $1.25 per share to fund the cashless exercise of 2,492 options.
( 2 )Stock options under the Issuer's 2011 Stock Option Plan. The option shares are fully vested.
( 3 )The transactions reported above in Table I reflect the cashless exercise of stock options. The cashless exercise for the options is reported in two lines. The lines coded M in column 3 of Table I report in column 4 the number of shares issuable upon exercise of the options had cash been paid to exercise the options, together with the exercise price with Code A for acquired. The lines coded F in column 3 of Table I relates to the same cashless exercise on the preceding line and reports in Column 4 the number of shares deducted from the total number of shares issuable to pay for the cashless exercise of such options with Code D for disposed.
( 4 )Where the number of shares deducted for cashless exercise is a fraction, the number has been rounded to the nearest whole number of shares. The number of shares on a net basis actually owned by the Reporting Person after the cashless exercise of each option is the amount by which the first line for each cashless exercise exceeds the second line for the same cashless exercise. All transactions are exempt from Section 16(b) by reason of Rule 16b-3. The transactions reported in Table II above, reflect the disposition of the same stock options whose cashless exercise is disclosed in Table I above.

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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