SEC Form 4 · accession 0000899243-17-027028

X4 Pharmaceuticals, Inc · XFOR

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owners

NeoMed Innovation V L.P.

10% Owner

NeoMed Management (Jersey) Ltd

10% Owner

NeoMed Innovation V Ltd

10% Owner

Period of report

Nov 20, 2017

Accepted (ET)

Nov 20, 2017 · 6:15 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001501697

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I
Common Stock^F1,F4	Nov 20, 2017	C	246,682	—	A	246,682	D
Common Stock^F2,F4	Nov 20, 2017	C	41,878	—	A	288,560	D
Common Stock^F3,F4	Nov 20, 2017	C	279,079	—	A	567,639	D
Common Stock^F4	Nov 20, 2017	P	300,000	$10.00	A	867,639	D

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	D/I
Series B Convertible Preferred Stock^F4,F1	—	Nov 20, 2017	C	552,487	D	—	—	Common Stock	246,682	D
Series C Convertible Preferred Stock^F4,F2	—	Nov 20, 2017	C	84,040	D	—	—	Common Stock	41,878	D
Series D Convertible Preferred Stock^F4,F3	—	Nov 20, 2017	C	952,497	D	—	—	Common Stock	279,079	D

Explanation of responses

F1The Series B Convertible Preferred Stock converted into Common Stock on a 0.44650-for-one basis upon the closing of the Issuer's initial public offering without payment of consideration. The Series B Convertible Preferred Stock was convertible at any time at the holder's election and automatically upon the closing at the Issuer's initial public offering. The shares had no expiration date.
F2The Series C Convertible Preferred Stock converted into Common Stock on a 0.49832-for-one basis upon the closing of the Issuer's initial public offering without payment of consideration. The Series C Convertible Preferred Stock was convertible at any time at the holder's election and automatically upon the closing at the Issuer's initial public offering. The shares had no expiration date.
F3The Series D Convertible Preferred Stock converted into Common Stock on a 0.29300-for-one basis upon the closing of the Issuer's initial public offering without payment of consideration. The Series D Convertible Preferred Stock was convertible at any time at the holder's election and automatically upon the closing at the Issuer's initial public offering. The shares had no expiration date.
F4The reported securities are held of record by NeoMed Innovation V L.P. NeoMed Management (Jersey) Limited is the Investment Manager to NeoMed Innovation V L.P. NeoMed Innovation V Limited is the general partner of Neomed Innovation V L.P. By virtue of such relationships, NeoMed Management (Jersey) Limited and NeoMed Innovation V Limited may be deemed to have voting and investment power with respect to the shares held by NeoMed Innovation V L.P. Each of NeoMed Management (Jersey) Limited and NeoMed Innovation V Limited disclaims beneficial ownership of the shares held by NeoMed Innovation V L.P., except to the extent of its or his pecuniary interest therein, if any.