Amended Statement of Changes in Beneficial Ownership (4/a)
20 Aprile 2021 - 10:30PM
Edgar (US Regulatory)
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 OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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Quinn Katherine B |
2. Issuer Name and Ticker or Trading Symbol
Ontrak, Inc.
[
OTRK
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
2120 COLORADO AVE., SUITE 230 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
8/10/2020 |
(Street)
SANTA MONICA, CA 90404
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
8/12/2020 |
6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security (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 |
Option (right to buy) | $59.36 | 8/10/2020 | | A (1) | | 2225 | | 9/30/2020 (2) | 8/10/2025 (3) | Ontrak, Inc. Common Stock | 2225 | $0 | 2225 | D | |
Explanation of Responses: |
(1) | These securities were granted to Ms. Quinn for her services as a member of the Company's Board of Directors. |
(2) | 1,112 options shall vest on September 30, 2020 and 1,113 options shall vest on December 31, 2020, such that all options shall be vested on December 31, 2020. The vesting of the options, as specified herein, will be subject to Ms. Quinn attending board meetings, unless such absence is excused by the Chairman of the board. |
(3) | The Form 4, as originally filed on August 12, 2020, incorrectly reported the expiration date of the option as August 10, 2030 |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Quinn Katherine B 2120 COLORADO AVE. SUITE 230 SANTA MONICA, CA 90404 | X |
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Signatures
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/s/Katherine B. Quinn | | 4/20/2021 |
**Signature of Reporting Person | Date |
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