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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
DEMANE MICHAEL F C/O NEVRO CORP. 4040 CAMPBELL AVENUE MENLO PARK, CA 94025 |
X | Chief Executive Officer |
/s/ Andrew Galligan, as Attorney-in-Fact for Michael DeMane | 09/03/2015 | |
**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) | The sales were effected pursuant to the Reporting Person's Rule 10b5-1 trading plan. |
(2) | The price reported in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $45.00 to $45.08, inclusive. The Reporting Person hereby undertakes to provide to the Securities and Exchange Commission staff, the Issuer, or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote. |
(3) | Includes 8,795 shares previously held by The Michael F. DeMane 2012 Retained Annuity Trust u/a/d July 26, 2012 which were distributed to the Reporting Person on November 28, 2014 and are now owned directly. |
(4) | Includes 1,076 shares previously held by The Michael F. DeMane 2013 Retained Annuity Trust which were distributed to the Reporting Person on April 13, 2015 and are now owned directly. |
(5) | The price reported in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $45.00 to $45.50, inclusive. The Reporting Person hereby undertakes to provide to the Securities and Exchange Commission staff, the Issuer, or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote. |
(6) | Shares held by The Michael F. DeMane 2013 Retained Annuity Trust. |
(7) | Shares held by The Michael F. DeMane 2012 Retained Annuity Trust u/a/d July 26, 2012. |