SEC FORM 4/A 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
 
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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*
Belloff Neil S.

(Last) (First) (Middle)
C/O ELOXX PHARMACEUTICALS, INC.
950 WINTER STREET

(Street)
WALTHAM MA 02451

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Eloxx Pharmaceuticals, Inc. [ ELOX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
COO, GENERAL COUNSEL &CORP SEC
3. Date of Earliest Transaction (Month/Day/Year)
01/30/2020
4. If Amendment, Date of Original Filed (Month/Day/Year)
01/31/2020
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
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
Common Stock 01/30/2020 M 6,250 A $0(1) 6,250 D
Common Stock 01/30/2020 F 2,166 D $3.91 4,084 D
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
Restricted Stock Units (1)(2) 01/30/2020 M 6,250(3) (1) (1) Common Stock 6,250 $0(4) 18,750(5) D
Explanation of Responses:
1. Reflects the restricted stock units issued to the reporting person on January 30, 2019 which have partially vested and settled for shares of the issuer's common stock. The original Form 4 filed on January 31, 2020 is amended in its entirety by this Form 4 Amendment to provide the: (a) correct date the restricted stock units were first issued to the reporting person; and (b) correct disposition of the derivative securities.
2. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock.
3. The original Form 4 filed on January 31, 2020 is amended by this Form 4 Amendment to correctly identify the nature of the transaction of the reporting person.
4. The restricted stock units were issued pursuant to the Issuer's 2018 Equity Incentive Plan.
5. The remaining restricted stock units will vest ratably each quarter through January 30, 2023, subject to the reporting person's continued employment with the Issuer, which vesting may be accelerated in certain circumstances.
/s/ Neil S. Belloff 03/04/2020
** 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).
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