SEC Form 4 · accession 0001104659-16-139282
MetaVia Inc. · MTVA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Andy Sassine
Director
Period of report
Aug 10, 2016
Accepted (ET)
Aug 12, 2016 · 1:24 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 StockF1 | Aug 10, 2016 | C | 75,080 | — | A | 75,080 | D | |
| Common Stock | Aug 10, 2016 | J | 8,212 | $6.7059 | A | 83,292 | D | |
| Common Stock | Aug 10, 2016 | C | 31,853 | $6.7059 | A | 115,145 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A Convertible Preferred StockF1 | — | Aug 10, 2016 | C | 75,080 | D | — | — | Common Stock | 75,080 | 0 | D |
| 8% Convertible Subordinated Promissory NotesF3 | $6.7059 | Aug 10, 2016 | C | — | D | — | — | Common Stock | 31,853 | 0 | D |
Explanation of responses
- 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.
- F2Represents shares of Common Stock issued for payment of accrued dividends on the Series A Convertible Preferred Stock.
- F3The notes were issued in the original principal amount of $200,000. The outstanding principal and $13,611 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.