SEC FORM
4
SEC Form 4
| FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
|
| OMB APPROVAL |
| OMB Number: |
3235-0287 |
| Estimated average burden |
| hours per response: |
0.5 |
|
|
 |
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
| C/O ARCTURUS THERAPEUTICS HOLDINGS INC. |
| 10628 SCIENCE CENTER DRIVE, SUITE 250 |
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
Arcturus Therapeutics Holdings Inc.
[ ARCT ]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
| X |
Director |
|
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
3. Date of Earliest Transaction
(Month/Day/Year)
10/25/2019
|
4. If Amendment, Date of Original Filed
(Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check Applicable Line)
| X |
Form filed by One Reporting Person |
|
Form filed by More than One Reporting Person |
|
| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
|---|
| 1. Title of Security (Instr.
3)
|
2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
|
4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
|
5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
|
6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
|
7. Nature of Indirect Beneficial Ownership (Instr.
4)
|
| Code |
V |
Amount |
(A) or (D) |
Price |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|---|
| 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 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: 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 |
| Stock Option (right to buy) |
$10.23
|
10/25/2019 |
|
A |
|
15,000 |
|
|
10/24/2029 |
Common Stock |
15,000 |
$0.00
|
15,000 |
D |
|
| Explanation of Responses: |
|
| Remarks: |
|
|
/s/ Ilan Katz, attorney-in-fact |
10/29/2019 |
|
** Signature of Reporting Person |
Date |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
| * 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). |
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
| 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 Number. |
EXHIBIT 24
POWER OF ATTORNEY
FOR SEC FILINGS ON FORMS ID, 3, 4, 5, 144, SCHEDULES 13D and 13G
IN RESPECT OF SECURITIES OF
ARCTURUS THERAPEUTICS HOLDINGS INC.
The undersigned hereby constitutes and appoints each of Jeffrey Baumel and
Ilan Katz as his or her true and lawful attorneys-in-fact and agents, each with
full power of substitution and resubstitution for him or her in his or her name
and stead in any and all capacities, to sign and file for and on his or her
behalf, in respect of any acquisition, disposition or other change in ownership
of any Common Stock or derivative securities thereof of Arcturus Therapeutics
Holdings Inc. (the "Company"), the following:
(i) any Form ID to be filed with the Securities and Exchange Commission
(the "SEC");
(ii) any Initial Statement of Beneficial Ownership of Securities on Form
3 to be filed with the SEC;
(iii) any Statement of Changes of Beneficial Ownership of Securities on
Form 4 to be filed with the SEC;
(iv) any Annual Statement of Beneficial Ownership of Securities on Form 5
to be filed with the SEC;
(v) any Notice of Proposed Sale of Securities on Form 144 to be filed
with the SEC;
(vi) and any other forms or reports the undersigned may be required to
file in connection with the undersigned's ownership, acquisition or
disposition of securities of the Company, including Schedules 13G
and 13D; and
(vii) any and all agreements, certificates, receipts, or other documents
in connection therewith. The undersigned hereby gives full power and
authority to each attorney-in-fact to seek and obtain as the
undersigned's representative and on the undersigned's behalf,
information on transactions in the Company's securities from any
third party, including brokers, employee benefit plan administrators
and trustees, and the undersigned hereby authorizes any such person
to release such information to the undersigned and approves and
ratifies any such release of information. The undersigned hereby
grants unto each attorney-in-fact and agent full power and authority
to do and perform each and every act and thing requisite and
necessary in connection with such matters and hereby ratifies and
confirms all that any such attorney-in-fact and agent or substitute
may do or cause to be done by virtue hereof. The undersigned
acknowledges that:
(i) neither the Company nor any of such attorney-in-fact assumes (i)
any liability for the undersigned's responsibility to comply
with the requirement of the Securities Exchange Act of 1934, as
amended (the "Exchange Act"), (ii) any liability of the
undersigned for any failure to comply with such requirements or
(iii) any obligation or liability of the undersigned for profit
disgorgement under Section 16(b) of the Exchange Act; and
(ii) this Power of Attorney does not relieve the undersigned from
responsibility for compliance with the undersigned's obligations
under the Exchange Act, including without limitation the
reporting requirements under Section 16 of the Exchange Act.
This Power of Attorney shall remain in full force and effect
until revoked by the undersigned in a signed writing delivered
to such attorney-in-fact.
[Signature Page Follows]
IN WITNESS WHEREOF, the undersigned has executed this Power of Attorney.
Date: August 15, 2019 /s/ James F. Barlow
--------------------
Name: James F. Barlow
