# EDGAR Filing Document

**Accession Number:** 0000876378
**File Stem:** 0001209191-23-007655
**Filing Date:** 2023-2
**Character Count:** 10075
**Document Hash:** e0349e9d6da8fc87a615f0bce5862909
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001209191-23-007655.hdr.sgml**: 20230207

**ACCESSION NUMBER**: 0001209191-23-007655

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230203

**FILED AS OF DATE**: 20230207

**DATE AS OF CHANGE**: 20230207

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Shameze Rampertab
- **CENTRAL INDEX KEY:** 0001721810

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 000-19437
- **FILM NUMBER:** 23596406

**MAIL ADDRESS:**
- **STREET 1:** C/O ZOMEDICA PHARMACEUTICALS CORP.
- **STREET 2:** 3928 VARSITY DRIVE
- **CITY:** ANN ARBOR
- **STATE:** MI
- **ZIP:** 48108
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** ASENSUS SURGICAL, INC.
- **CENTRAL INDEX KEY:** 0000876378
- **STANDARD INDUSTRIAL CLASSIFICATION:** SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
- **IRS NUMBER:** 112962080
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 1 TW ALEXANDER DRIVE
- **STREET 2:** SUITE 160
- **CITY:** DURHAM
- **STATE:** NC
- **ZIP:** 27703
- **BUSINESS PHONE:** 919-765-8400

**MAIL ADDRESS:**
- **STREET 1:** 1 TW ALEXANDER DRIVE
- **STREET 2:** SUITE 160
- **CITY:** DURHAM
- **STATE:** NC
- **ZIP:** 27703

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** TRANSENTERIX, INC.
- **DATE OF NAME CHANGE:** 20190712

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** TRANSENTERIX INC.
- **DATE OF NAME CHANGE:** 20131210

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** SafeStitch Medical, Inc.
- **DATE OF NAME CHANGE:** 20080211

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Shameze Rampertab<br><sub>(Last) (First) (Middle)</sub><br>C/O ASENSUS SURGICAL, INC.<br>1 TW ALEXANDER DRIVE, SUITE 160<br><sub>(Street)</sub><br>DURHAM, NC 27703<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-03 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_EVP, Chief Financial Officer_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>ASENSUS SURGICAL, INC. [ ASXC ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock | 2023-02-04 |  | M |  | 248512 | A | $0.00 | 342170 | D |  |
| Common Stock | 2023-02-04 |  | F<sup>(1)</sup> |  | 103998 | D | $0.75 | 238172 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Stock Options | $0.75 | 2023-02-03 |  | A |  | 175000 |  | <sup>(2)</sup> | 2030-02-03 | Common Stock | 175000 | $0.00 | 175000 | D |  |
| Restricted Stock Units<sup>(3)</sup> | $0.00 | 2023-02-03 |  | A |  | 175000 |  | <sup>(4)</sup> | <sup>(4)</sup> | Common Stock | 175000 | $0.00 | 175000 | D |  |
| Restricted Stock Units<sup>(5)</sup> | $0.00 | 2023-02-03 |  | A |  | 350000 |  | <sup>(6)</sup> | <sup>(6)</sup> | Common Stock | 350000 | $0.00 | 350000 | D |  |
| Restricted Stock Units<sup>(3)</sup> | $0.00 | 2023-02-04 |  | M |  |  | 84270 | <sup>(7)</sup> | <sup>(7)</sup> | Common Stock | 84270 | $0.00 | 0 | D |  |
| Restricted Stock Units<sup>(3)</sup> | $0.00 | 2023-02-04 |  | M |  |  | 19704 | <sup>(8)</sup> | <sup>(8)</sup> | Common Stock | 19704 | $0.00 | 19704 | D |  |
| Restricted Stock Units<sup>(5)</sup> | $0.00 | 2023-02-04 |  | M |  |  | 19704 | <sup>(9)</sup> | <sup>(9)</sup> | Common Stock | 19704 | $0.00 | 19704 | D |  |
| Restricted Stock Units<sup>(3)</sup> | $0.00 | 2023-02-04 |  | M |  |  | 62417 | <sup>(10)</sup> | <sup>(10)</sup> | Common Stock | 62417 | $0.00 | 124833 | D |  |
| Restricted Stock Units<sup>(5)</sup> | $0.00 | 2023-02-04 |  | M |  |  | 62417 | <sup>(11)</sup> | <sup>(11)</sup> | Common Stock | 62417 | $0.00 | 124833 | D |  |

---

### Footnotes:

(1) This transaction represents the payment of a tax liability on the lapse of forfeiture restrictions on a derivative security and acquisition of the underlying shares.

(2) Vests one-third annually on each of February 3, 2024, 2025 and 2026, subject to acceleration as set forth in the Registrant's Amended and Restated Incentive Compensation Plan ("Plan") and the Reporting Person's Employment Agreement with the Registrant ("Employment Agreement").

(3) Each restricted stock unit ("RSU") represents the right to receive one share of the Registrant's common stock.

(4) Forfeiture restrictions will lapse on the RSUs in three equal installments on each of February 4, 2024, 2025 and 2026, as long as the Reporting Person remains in continuous service during the vesting period, subject to acceleration as set forth in the Plan and the Employment Agreement.

(5) Each performance-based restricted stock unit ("PRSU") represents the right to receive one share of the Registrant's common stock.

(6) PRSU award with time-based vesting in three equal installments on each of February 4, 2024, 2025 and 2026, and performance-based vesting only if designated corporate goals are met.

(7) Lapse of forfeiture restrictions on discretionary bonus RSUs.

(8) Lapse of forfeiture on second one-third of an award of RSUs from this grant made on February 8, 2021.  Forfeiture restrictions will lapse on the remaining RSUs on February 4, 2024, as long as the Reporting Person remains in continuous service during the vesting period, subject to acceleration as set forth in the Registrant's Plan and the Reporting Person's Employment Agreement.

(9) Lapse of forfeiture restrictions on second one-third of a PRSU award granted on February 8, 2021, upon the achievement of time and performance goals.  Forfeiture restrictions will lapse on the remaining PRSUs on February 4, 2024, as long as the Reporting Person provides continuous service during the vesting period, subject to acceleration as set forth in the Registrant's Plan and the Reporting Person's Employment Agreement.

(10) Lapse of forfeiture restrictions on one-third of a RSU award granted on February 4, 2022.  Forfeiture restrictions will lapse on the remaining RSUs on February 4, 2024 and 2025, as long as the Reporting Person provides continuous service to the Company during the vesting period and subject to acceleration as set forth in the Registrant's Plan and the Reporting Person's Employment Agreement.

(11) Lapse of forfeiture restrictions on one-third of a PRSU award granted on February 4, 2022 upon the achievement of time and performance goals. Forfeiture restrictions will lapse on the remaining PRSUs on each of February 4, 2024 and 2025, subject to acceleration as set forth in the Registrant's Plan and the Reporting Person's Employment Agreement.

**Signature:** /s/ Joshua Weingard, as attorney-in-fact for Shameze Rampertab  
**Date:** 2023-02-07

### Remarks:

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.**