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*
Fernandez Charles M.

(Last) (First) (Middle)
C/O NEXTPLAT CORP, 3250 MARY ST.,
SUITE 410

(Street)
COCONUT GROVE FL 33133

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
NextPlat Corp [ NXPL ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman & CEO
3. Date of Earliest Transaction (Month/Day/Year)
07/01/2022
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 Stock, par value $0.0001 per share 07/22/2022 A 200,000 A $5 1,749,453(2) I Shares held by eApeiron Partners, LLC.(1)
Common Stock, par value $0.0001 per share 09/20/2022 A 116,000 A $0.00 1,865,453(3) I Shares held by eApeiron Partners, LLC(1)
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 Options $2.13 07/01/2022 A 70,000 07/01/2022 07/01/2032 Common Stock 70,000(4) $0.00(5) 707,500 D
Explanation of Responses:
1. Mr. Fernandez is the sole member and managing partner of eApeiron Partners LLC.
2. Includes 200,000 shares of common stock held by eApeiron Partners LLC, of which Mr. Fernandez is sole member and managing partner.
3. Includes 316,000 shares of restricted common stock held by eApeiron Partners LLC, of which Mr. Fernandez is sole and managing partner.
4. On July 1, 2022, Mr. Fernandez was granted an option to purchase 70,000 shares of common stock. The option was fully vested, issued outside of any equity compensation plan, with an exercise price of $2.13, and a term of ten years.
5. The stock options were granted as an equity incentive award.
/s/ Charles M. Fernandez 10/06/2022
** 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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