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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series A Preferred Stock | (1) | 07/30/2013 | C(1) | 162,356 | (1) | (1) | Common Stock | 19,679 | (1) | 0 | I | See footnote (6) | |||
Stock Option (Right to Buy) | $ 11 | 07/30/2013 | A | 50,000 | (7) | 07/29/2023 | Common Stock | 50,000 | $ 0 | 50,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
HALE DAVID F C/O CONATUS PHARMACEUTICALS INC. 4365 EXECUTIVE DRIVE, SUITE 200 SAN DIEGO, CA 92121 |
X |
/s/ Charles J. Cashion, Attorney-in-Fact for David F. Hale | 08/01/2013 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The outstanding shares of Preferred Stock of the Issuer automatically converted into the shares of Common Stock of the Issuer at the closing of the Issuer's initial public offering (the "IPO") at a conversion ratio of 1 share of Common Stock for every 8.25 shares of Preferred Stock, rounded down to the nearest whole number, for no additional consideration. |
(2) | Represents 128,769 shares held by Hale BioPharma Ventures, LLC and 12,121 shares held by Hale Trading Company, LP. Mr. Hale holds sole voting and investment power with respect to the shares held by these entities. |
(3) | The common stock was acquired upon conversion of a convertible promissory note exempt from the definition of a derivative security because the conversion price did not become fixed until automatic conversion at the time of the closing of the IPO. |
(4) | Represents 129,030 shares held by Hale BioPharma Ventures, LLC and 12,121 shares held by Hale Trading Company, LP. Mr. Hale holds sole voting and investment power with respect to the shares held by these entities. |
(5) | Represents 131,618 shares held by Hale BioPharma Ventures, LLC and 12,121 shares held by Hale Trading Company, LP. Mr. Hale holds sole voting and investment power with respect to the shares held by these entities. |
(6) | Held by Hale BioPharma Ventures, LLC of which Mr. Hale serves as CEO. Mr. Hale holds sole voting and investment power with respect to the securities held by that entity. |
(7) | The shares subject to this option become exercisable as they vest. One-third of the total number of shares subject to this option vests and becomes exercisable on each anniversary of the grant date, so that the entire number of shares subject to this option becomes fully vested and exercisable on the third anniversary of the grant date. |