SEC Form 4 · accession 0001144204-15-032128

Jaguar Health, Inc. · JAGX

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

Reporting owner

Director

Period of report

May 18, 2015

Accepted (ET)

May 18, 2015 · 6:07 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001585608

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F2	May 18, 2015	C	148,332	—	A	247,220	I	By Bochnowski Family Trust
Common Stock^F2	May 18, 2015	C	35,714	$5.60	A	282,934	I	By Bochnowski Family Trust
Common Stock^F2	May 18, 2015	C	44,642	$5.60	A	327,576	I	By Bochnowski Family Trust

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	D/I
Series A Preferred Stock^F2,F1	—	May 18, 2015	C	224,499	D	—	—	Common Stock	148,332	I
Convertible Promissory Note^F2,F3	$5.60	May 18, 2015	C	—	D	—	—	Common Stock	35,714	I
Convertible Promissory Note^F2,F3	$5.60	May 18, 2015	C	—	D	—	—	Common Stock	44,642	I

F1These securities automatically converted into Issuer's common stock on a 1.5 to 1 basis immediately prior to the consummation of Issuer's initial public offering ("IPO") and had no expiration date.
F2The Reporting Person is a co-trustee and beneficiary of such trust, and shares voting and investment control over such shares with his spouse.
F3These notes automatically converted into shares of common stock upon consummation of Issuer's IPO.