Home/Filings/4/0001185185-19-000332
4//SEC Filing

Kubota Lauren 4

Accession 0001185185-19-000332

CIK 0001138476other

Filed

Mar 11, 8:00 PM ET

Accepted

Mar 12, 12:29 PM ET

Size

6.6 KB

Accession

0001185185-19-000332

Insider Transaction Report

Form 4
Period: 2018-05-14
Transactions
  • Other

    Employee Stock Options

    2018-05-144,0000 total
    Exercise: $3.75From: 2018-08-17Exp: 2022-08-17Common (4,000 underlying)
Holdings
  • Common

    2,000
Footnotes (2)
  • [F1]Adjusted to reflect the four-shares-for-one-share forward split of the Company's common stock that took effect on April 5, 2018.
  • [F2]On May 14, 2018, the Reporting Person executed a Stock Cancellation Agreement forfeiting unvested employee stock options she held to purchase 4,000 post-split shares of Common Stock of the Issuer (the "Forfeited Options") without any expectation to receive, and without any obligation on the Issuer to pay or grant, any cash, equity awards or other consideration presently or in the future with respect to the Forfeited Options.

Documents

1 file

Issuer

PACIFIC HEALTH CARE ORGANIZATION INC

CIK 0001138476

Entity typeother

Related Parties

1
  • filerCIK 0001732009

Filing Metadata

Form type
4
Filed
Mar 11, 8:00 PM ET
Accepted
Mar 12, 12:29 PM ET
Size
6.6 KB