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*
Shah Baiju R.

(Last) (First) (Middle)
ONE INVACARE WAY

(Street)
ELYRIA OH 44035

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
INVACARE CORP [ IVC ]
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)
03/12/2021
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
Common Shares 03/12/2021 A 13,388(1) A $0.00 89,813(2) 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
Stock Option (Right to Buy) (3) (4) (4) Common Shares 4,496 4,496(4) D
Explanation of Responses:
1. Restricted stock units granted pursuant to the Invacare Corporation 2018 Equity Compensation Plan in an exempt transaction under Rule 16b-3. These restricted stock units vest in full on May 15, 2022.
2. Includes 48,798 previously reported restricted stock units issued pursuant to the Invacare Corporation 2013 Equity Compensation Plan and the Invacare Corporation 2018 Equity Compensation Plan. 8,606 of these restricted stock units vested in full on 05/15/18; however, the reporting person has elected to defer receipt of the common shares issuable upon the vesting of these restricted stock units until the earlier of January 1, 2027 or his separation from the issuer, pursuant to the Invacare Corporation 2012 Non-Employee Directors Deferred Compensation Plan. 6,708 of these restricted stock units vested in full on 05/15/19; however, the reporting person has elected to defer receipt of the common shares issuable upon vesting of these restricted stock units until the earlier of January 1, 2027 or his separation from the issuer, pursuant to the 2012 Invacare Corporation Non-Employee Directors Deferred Compensation Plan. 15,439 of these restricted stock units vest in full on 05/15/21.
3. No transaction is being reported on this line. Reported on a previously filed Form 3, Form 4, or Form 5.
4. The reporting person holds previously reported options to buy 4,496 Common Shares (with tandem tax withholding rights) under the Invacare Corporation 2003 Performance Plan, granted in reliance upon the exemption provided by Rule 16b-3. All options were granted on May 19, 2011, at an exercise price of $33.36 per share, will expire on May 19, 2021, and became exercisable between March 31, 2012 and March 31, 2015.
Remarks:
/s/ Baiju R. Shah, by Kristofer K. Spreen, his attorney-in-fact pursuant to Power of Attorney, dated May 12, 2011, on file with the Commission 03/16/2021
** 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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