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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 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 (Month/Day/Year) |
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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option (Right to Buy) | $ 3.25 (1) | 12/29/2011 | A | 10,000 (1) (3) | 12/31/2011 | 12/29/2016 | Common Stock | 10,000 (1) | $ 0 | 10,000 | D | ||||
Stock Option (Right to Buy) | $ 3.25 (1) | 12/29/2011 | A | 390,000 (1) (2) | 12/29/2011(2) | 12/29/2016 | Common Stock | 390,000 (2) | $ 0 | 390,000 (2) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
POTASHNER KENNETH F C/O MAXWELL TECHNOLOGIES INC 9244 BALBOA AVE SAN DIEGO, CA 92123 |
X | Executive Chairman |
/s/ James A Barnes as Attorney-in-Fact for Kenneth F. Potashner | 04/04/2012 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | All shares and exercise prices reflect a 1 for 5 reverse stock split effected by the Company on March 21, 2012. |
(2) | On April 3, 2012 the vesting for these options was modified from 10% at grant and the balance over two years (each calendar quarter) to a new vesting schedule of 10% at grant (41,000 vested), 154,000 vesting on April 3, 2012, 195,000 vesting quarterly over eight calendar quarters commencing March 31, 2012 and 20,000 on performance. The 20,000 vesting on performance are not considered derivative securities for purposes of Section 16 and accordingly the grant total as amended has been reduced from 410,000 to 390,000 (giving effect to the reverse stock split). |
(3) | Options vest over eight calendar quarters with first 12.5% vested on December 31, 2011, subject to the terms of the 2012 Stock Plan and option agreement. There was no modification to this option grant. |
Remarks: Amended filing to reflect modification of vesting on April 3, 2012 to previously granted stock option. |