REBACK ROBERT H 5

5 · CIMETRIX INC · Filed Apr 4, 2012

Form 5

Period: 2011-12-31

PRESIDENT AND CEO

Transactions

Exercise/Conversion
COMMON STOCK
2011-08-01$0.05/sh+25,000$1,250→ 25,000 total(indirect: By 401(k))
Award
Warrant (right to buy)
2002-11-11+12,500→ 12,500 total(indirect: By IRA)
Exercise: $0.35From: 2002-11-11Exp: 2005-09-30→ Common Stock (12,500 underlying)
Exercise/Conversion
COMMON STOCK
2011-02-28$0.05/sh+12,500$625→ 12,500 total(indirect: By IRA)
Award
Warrant (right to buy)
2009-01-26+25,000→ 25,000 total(indirect: By 401(k))
Exercise: $0.05From: 2009-01-26Exp: 2010-09-30→ Common Stock (25,000 underlying)
Award
Warrant (right to buy)
2002-11-15+25,000→ 25,000 total(indirect: By IRA)
Exercise: $0.35From: 2002-11-05Exp: 2005-09-30→ Common Stock (25,000 underlying)
Exercise/Conversion
COMMON STOCK
2011-02-28$0.05/sh+25,000$1,250→ 37,500 total(indirect: By IRA)

Holdings

Footnotes (4)

[F1]This warrant was granted on 11/11/2002. The expiration date of the warrant was extended with Board approval on each of 9/8/2004, 6/5/2006, 3/22/2007, 9/3/2008 and 12/15/2009. The final expiration date of the warrant was 9/30/2012. The exercise price of the warrant was changed to $0.05 in connection with the extension of the expiration date on 9/3/2008. The warrant was exercised on 2/28/2011.
[F2]This warrant was granted on 11/15/2002. The expiration date of the warrant was extended with Board approval on each of 9/8/2004, 6/5/2006, 3/22/2007, 9/3/2008 and 12/15/2009. The final expiration date of the warrant was 9/30/2012. The exercise price of the warrant was changed to $0.05 in connection with the extension of the expiration date on 9/3/2008. The warrant was exercised on 2/28/2011
[F3]This warrant was granted on 1/26/09. The expiration date of the warrant was extended with Board approval to 9/30/2012 on 12/15/2009. The warrant was exercised on 8/1/2011.
[F4]This information is based on a 401(k) plan statement dated as of 12/31/2011.

Documents

1 file