SEC Form 4 · accession 0001094891-18-000046
PAVmed Inc. · PAVM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owners
Lishan Aklog
Officer — Chairman and CEO · Director · 10% Owner
HCFP/Capital Partners III LLC
10% Owner
Pavilion Venture Partners LLC
10% Owner
Period of report
Feb 14, 2018
Accepted (ET)
Feb 16, 2018 · 4:25 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001624326
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Feb 2, 2018 | G | 34,153 | $0.00 | D | 588,413 | D | |
| Common Stock | holding | — | — | — | 1,285 | I | By daughter | |
| Common Stock | holding | — | — | — | 1,300 | I | By son | |
| Common StockF2 | holding | — | — | — | 4,456,570 | I | By Pavilion Venture Partners LLC | |
| Common StockF3 | holding | — | — | — | 20,000 | I | By HCFP/AG LLC |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (Right to Buy)F4 | $2.01 | Feb 14, 2018 | A | 195,108 | A | — | Feb 14, 2028 | Common Stock | 195,108 | 195,108 | D |
Explanation of responses
- F1The reporting person transferred these shares of common stock by bona fide gift to a third party.
- F2Dr. Aklog is a member and sole manager of Pavilion Venture Partners LLC, and has sole voting and dispositive power over the shares held by this entity. Dr. Aklog disclaims beneficial ownership of shares held by this entity, except to the extent of his proportionate pecuniary interest therein.
- F3Dr. Aklog is a co-manager of HCFP/AG LLC, and shares joint voting and dispositive power over the shares held by this entity. Dr. Aklog disclaims beneficial ownership of shares held by this entity, except to the extent of his pecuniary interest therein.
- F4The option vests in 12 equal quarterly installments commencing on March 31, 2018.
Remarks
The reporting person no longer has a reportable beneficial interest in the following securities, which were included in the reporting person's prior ownership reports: (i) 125,000 shares of common stock and 125,000 warrants distributed by HCFP/Capital Partners IIIB LLC to its members on a pro rata basis (none of which were distributed to the reporting person); and (ii) 87,020 shares of common stock and 387,020 warrants held by HCFP Inc., over which the reporting person ceased to have investment control.