Filing Details

Accession Number:
0001209191-13-011587
Form Type:
4
Zero Holdings:
No
Publication Time:
2013-02-26 16:19:15
Reporting Period:
2013-02-22
Filing Date:
2013-02-26
Accepted Time:
2013-02-26 16:19:15
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1371217 Enteromedics Inc ETRM Electromedical & Electrotherapeutic Apparatus (3845) 000000000
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1132859 Kevin Douglas 125 E. Sir Francis Drake Blvd., Ste 400
Larkspur CA 94939
No No Yes Yes
1268474 Trust Family Douglas 125 E. Sir Francis Drake Blvd., Ste 400
Larkspur CA 94939
No No Yes Yes
1268475 Trust Descendants Irrevocable Douglas Jean & James 125 E. Sir Francis Drake Blvd., Ste 400
Larkspur CA 94939
No No Yes Yes
1348445 Michelle Douglas 125 E. Sir Francis Drake Blvd., Ste 400
Larkspur CA 94939
No No Yes Yes
1518639 Vi Trust Annuity 2010 Mmd 125 E. Sir Francis Drake Blvd., Ste 400
Larkspur CA 94939
No No Yes Yes
1518640 Vi Trust Annuity 2010 Kgd 125 E. Sir Francis Drake Blvd., Ste 400
Larkspur CA 94939
No No Yes Yes
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2013-02-22 630,000 $0.00 3,010,852 No 4 P Direct
Common Stock Acquisiton 2013-02-22 1,050,000 $0.00 3,456,512 No 4 P Indirect By James Douglas and Jean Douglas Irrevocable Descendants' Trust
Common Stock Acquisiton 2013-02-22 420,000 $0.00 1,654,341 No 4 P Indirect By Douglas Family Trust
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Direct
No 4 P Indirect By James Douglas and Jean Douglas Irrevocable Descendants' Trust
No 4 P Indirect By Douglas Family Trust
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Warrant (Right to Buy) Acquisiton 2013-02-22 252,000 $0.00 252,000 $1.14
Common Stock Warrant (Right to Buy) Acquisiton 2013-02-22 420,000 $0.00 420,000 $1.14
Common Stock Warrant (Right to Buy) Acquisiton 2013-02-22 168,000 $0.00 168,000 $1.14
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
252,000 2018-02-27 No 4 P Direct
420,000 2018-02-27 No 4 P Indirect
168,000 2018-02-27 No 4 P Indirect
Reported Non-Derivative Holdings
Sec. Name Remaning Holdings Nature of Ownership Explanation
Common Stock 0 Indirect By KGD 2010 Annuity Trust VI
Common Stock 0 Indirect By MMD 2010 Annuity Trust VI
Reported Derivative Holdings
Sec. Name Sec. Type Price Date Expiration Date Amount Remaning Holdings Nature of Ownership
Common Stock Warrant (Right to Buy) $2.19 2016-06-13 510,000 510,000 Direct
Common Stock Warrant (Right to Buy) $2.19 2016-06-13 850,000 850,000 Indirect
Common Stock Warrant (Right to Buy) $2.19 2016-06-13 340,000 340,000 Indirect
Common Stock Warrant (Right to Buy) $2.19 2016-06-13 0 0 Indirect
Common Stock Warrant (Right to Buy) $2.19 2016-06-13 0 0 Indirect
Common Stock Warrant (Right to Buy) $1.90 2016-09-28 87,000 87,000 Direct
Common Stock Warrant (Right to Buy) $1.90 2016-09-28 145,000 145,000 Indirect
Common Stock Warrant (Right to Buy) $1.90 2016-09-28 58,000 58,000 Indirect
Expiration Date Amount Remaning Holdings Nature of Ownership
2016-06-13 510,000 510,000 Direct
2016-06-13 850,000 850,000 Indirect
2016-06-13 340,000 340,000 Indirect
2016-06-13 0 0 Indirect
2016-06-13 0 0 Indirect
2016-09-28 87,000 87,000 Direct
2016-09-28 145,000 145,000 Indirect
2016-09-28 58,000 58,000 Indirect
Footnotes
  1. These shares are held directly and jointly by Kevin Douglas and Michelle Douglas.
  2. Each of the reporting persons hereunder (individually, a "Reporting Person" and collectively the "Reporting Persons") may be deemed a member of a "group" within the meaning of Section 13(d)(3) of the Securities and Exchange Act of 1934, as amended (the "Exchange Act") or Rule 13d-5 promulgated under the Exchange Act, with one or more of the other Reporting Persons. Although the Reporting Persons are reporting such securities as if they were members of a "group", the filing of this Form 4 shall not be deemed an admission by any Reporting Person that such Reporting Person is a beneficial owner of any securities other than those directly held by such Reporting Person.
  3. These shares are held directly by the James Douglas and Jean Douglas Irrevocable Descendants' Trust and indirectly by Kevin Douglas and Michelle Douglas. Kevin Douglas and Michelle Douglas, husband and wife, are each a co-trustee of the James Douglas and Jean Douglas Irrevocable Descendants' Trust.
  4. These shares are held directly by the Douglas Family Trust and indirectly by Kevin Douglas. James E. Douglas, Jr. and Jean A. Douglas, husband and wife, are each a co-trustee of the Douglas Family Trust.
  5. These shares are held directly by the KGD 2010 Annuity Trust, a grantor-retained annuity trust of which Kevin Douglas is the sole trustee, and indirectly by Kevin Douglas.
  6. These shares are held directly by the MMD 2010 Annuity Trust, a grantor-retained annuity trust of which Michelle Douglas is the sole trustee, and indirectly by Michelle Douglas and Kevin Douglas.
  7. On December 27, 2010, the Reporting Person contributed 127,500 shares to the KGD 2010 Annuity Trust VI, a grantor-retained annuity trust of which Kevin Douglas is the sole trustee. On February 21, 2012, 125,510 shares were distributed to the Reporting Person and are reported in this Form 4 as held directly and jointly by Kevin Douglas and Michelle Douglas. Upon successful completion of the GRAT on January 28, 2013, 1,990 shares were distributed to the Reporting Person and are reported on this Form 4 as held directly and jointly by Kevin Douglas and Michelle Douglas.
  8. On December 27, 2010, the Reporting Person contributed 127,500 shares to the MMD 2010 Annuity Trust VI, a grantor-retained annuity trust of which Michelle Douglas is the sole trustee. On February 21, 2012, 125,510 shares were distributed to the Reporting Person and are reported in this Form 4 as held directly and jointly by Kevin Douglas and Michelle Douglas. Upon successful completion of the GRAT on January 28, 2013, 1,990 shares were distributed to the Reporting Person and are reported on this Form 4 as held directly and jointly by Kevin Douglas and Michelle Douglas.
  9. The reported securities are included within 630,000 EnteroMedics units purchased by the Reporting Person for $0.95 per unit. Each unit consists of one share of common stock and a warrant to purchase 0.40 of a share of common stock.
  10. The reported securities are included within 1,050,000 EnteroMedics units purchased by the Reporting Person for $0.95 per unit. Each unit consists of one share of common stock and a warrant to purchase 0.40 of a share of common stock.
  11. The reported securities are included within 420,000 EnteroMedics units purchased by the Reporting Person for $0.95 per unit. Each unit consists of one share of common stock and a warrant to purchase 0.40 of a share of common stock.
  12. This warrant is exercisable at any time up and including the expiration date. The terms of this warrant contain a limitation on conversion which prevents the Reporting Person from converting this warrant into shares if, after giving effect to the conversion, the Reporting Person would beneficially own more than 19.99% of the issuer's outstanding shares.
  13. On December 27, 2010, the Reporting Person contributed warrants to purchase 127,500 shares to the KGD 2010 Annuity Trust VI, a grantor-retained annuity trust of which Kevin Douglas is the sole trustee. On February 21, 2012, warrants to purchase 125,510 shares were distributed to the Reporting Person and are reported in this Form 4 as held directly and jointly by Kevin Douglas and Michelle Douglas. Upon successful completion of the GRAT on January 28, 2013, warrants to purchase 1,990 shares were distributed to the Reporting Person and are reported on this Form 4 as held directly and jointly by Kevin Douglas and Michelle Douglas.
  14. On December 27, 2010, the Reporting Person contributed warrants to purchase 127,500 shares to the MMD 2010 Annuity Trust VI, a grantor-retained annuity trust of which Michelle Douglas is the sole trustee. On February 21, 2012, warrants to purchase 125,510 shares were distributed to the Reporting Person and are reported in this Form 4 as held directly and jointly by Kevin Douglas and Michelle Douglas. Upon successful completion of the GRAT on January 28, 2013, warrants to purchase 1,990 shares were distributed to the Reporting Person and are reported on this Form 4 as held directly and jointly by Kevin Douglas and Michelle Douglas.