SEC Form 4 · accession 0001179110-17-010722
Apollo Endosurgery, Inc. · APEN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Rick D Anderson
Director · 10% Owner
Period of report
Jul 25, 2017
Accepted (ET)
Jul 26, 2017 · 6:39 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001251769
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Jul 25, 2017 | P | 45,454 | $5.50 | A | 45,454 | D | |
| Common StockF1 | Jul 25, 2017 | P | 1,090,909 | $5.50 | A | 1,090,909 | I | By PTV Evergreen Fund, LP |
| Common StockF2 | holding | — | — | — | 5,243,372 | I | See footnote |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1These securities are held in the name of PTV Evergreen Fund, LP. PTV Healthcare Capital has sole voting and investment control over the shares owned by PTV Evergreen Fund, LP. The Managing Directors of PTV Healthcare Capital have shared voting and investment control over the shares owned by PTV Evergreen Fund, LP. The Reporting Person is a Managing Director of PTV Healthcare Capital and may be deemed to be the beneficial owner of the securities held by PTV Evergreen Fund, LP.
- F2Includes (i) 1,347,565 shares of common stock held by PTV IV, L.P., (ii) 605,712 shares of common stock held by PTV Special Opportunities I, L.P., (iii) 2,199,186 shares of common stock held by PTV Sciences II, L.P., and (iv) 1,090,909 shares held by PTV Evergreen Fund, LP. PTV Healthcare Capital has sole voting and investment control over the shares owned by PTV IV, L.P., PTV Special Opportunities I, L.P., PTV Sciences II, L.P., and PTV Evergreen Fund, LP. The Reporting Person is a Managing Director of PTV Healthcare Capital and may be deemed to be the beneficial owner of the securities held by PTV IV, L.P., PTV Special Opportunities I, L.P., PTV Sciences II, L.P., and PTV Evergreen Fund, LP.
Remarks
Exhibit Index: Exhibit 24 - Power of Attorney (incorporated by reference to the Power of Attorney filed as Exhibit 24 to the Form 3 filed by the Reporting Person on December 29, 2016)