SEC Form 4 · accession 0001104659-16-139276

MetaVia Inc. · MTVA

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

Reporting owner

Director

Period of report

Aug 10, 2016

Accepted (ET)

Aug 12, 2016 · 1:15 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001638287

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F2	Aug 10, 2016	C	95,439	—	A	95,439	I	Held by BWA Gemphire Investment Group, LLC
Common Stock^F2	Aug 10, 2016	J	10,439	$6.7059	A	105,878	I	Held by BWA Gemphire Investment Group, LLC
Common Stock^F4	Aug 10, 2016	C	116,891	$6.7059	A	116,891	I	Held by BWA Gemphire Investment Group II, LLC
Common Stock	Aug 10, 2016	P	1,000	$10.00	A	1,000	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Series A Convertible Preferred Stock^F2,F1	—	Aug 10, 2016	C	95,439	D	—	—	Common Stock	95,439	0	I
8% Convertible Subordinated Promissory Notes^F5,F4	$6.7059	Aug 10, 2016	C	—	D	—	—	Common Stock	116,891	0	I

F1The Series A Convertible Preferred Stock converted into shares of common stock, par value $0.001 per share (the "Common Stock"), of Gemphire Therapeutics Inc. (the "Company") on a one-for-one basis immediately prior to the closing of the Company's initial public offering and had no expiration date.
F2Mr. Kousky, as the Manager of BWA Gemphire Investment Group, LLC ("BWA"), beneficially owns the reported securities indirectly, but disclaims beneficial ownership of the securities held by BWA except to the extent of his pecuniary interest therein.
F3Represents shares of Common Stock issued for payment of accrued dividends on the Series A Convertible Preferred Stock.
F4Mr. Kousky, as the Manager of BWA Gemphire Investment Group II, LLC ("BWA II"), beneficially owns the reported securities indirectly, but disclaims beneficial ownership of the securities held by BWA II except to the extent of his pecuniary interest therein.
F5The notes were issued in the original principal amount of $746,500. The outstanding principal and $37,367 of accrued interest on the notes automatically converted into shares of Common Stock immediately prior to the closing of the Company's initial public offering.