SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Siegel Seth M

(Last) (First) (Middle)
C/O VRINGO, INC.
18 E. 16TH ST., 7TH FLOOR

(Street)
NEW YORK NY 10003

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/21/2010
3. Issuer Name and Ticker or Trading Symbol
Vringo Inc [ VRNGU ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 68,608 D
Common Stock 19,165 I By Seth Mitchell Siegel Family Trust
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Options(1) 10/30/2006 10/30/2012 Common Stock 13,333 1.5 D
Stock Options(2) (2) (2) Common Stock 100,000 0.01 D
Stock Options(3) (3) (3) Common Stock 100,000 5.5 D
Warrants 12/29/2009 12/29/2014 Common Stock 28,985 2.75 D
Warrants (4) (4) Common Stock 57,970 5.06 D
Explanation of Responses:
1. The Stock Options were granted on October 30, 2006. One-fourth of the grant became exercisable six months after the date of the grant, with the remainder becoming exercisable in equal quarterly installments over the following three years.
2. The Stock Options were granted on March 17, 2010. One-third of the grant becomes exercisable one year after the consummation of the company's initial public offering, with the remainder becoming exercisable in equal annual installments over the following two years. The stock options will expire six years following the company's initial public offering.
3. The Stock Options were granted on March 17, 2010. One-fourth of the grant becomes exercisable one year after the consummation of the company's initial public offering, with the remainder becoming exercisable in equal quarterly installments over the following three years. The stock options will expire six years following the company's initial public offering.
4. The Warrants will be exercisable upon the consummation of the company's initial public offering and will expire five years thereafter.
/s/ Seth M. Siegel 06/21/2010
** 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 5 (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.