SEC Form 4 · accession 0001209191-16-152513
Outlook Therapeutics, Inc. · OTLK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kurt J Hilzinger
Director
Period of report
Nov 28, 2016
Accepted (ET)
Nov 30, 2016 · 5:25 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001649989
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Nov 28, 2016 | J | 11,633 | $0.00 | A | 11,633 | D | |
| Common StockF2 | Nov 30, 2016 | J | 6,885 | $0.00 | A | 18,518 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant (Right to Buy)F3,F4 | $0.01 | Nov 28, 2016 | J | 12,036 | A | — | Nov 8, 2019 | Common Stock | 12,036 | 12,036 | D |
Explanation of responses
- F1Represents the receipt of 11,633 shares of Common Stock in a pro rata distribution for no consideration from Proximare Lifesciences Fund LLC, of which the reporting person is a member.
- F2Represents the receipt of 6,885 shares of Common Stock in a pro rata distribution for no consideration from Proximare Lifesciences Fund 2 LLC, of which the reporting person is a member.
- F3Represents the receipt of (i) a Warrant to purchase 7,561 from Proximare Lifesciences Fund LLC, of which the reporting person is a member, and (ii) a Warrant to purchase 4,475 from Proximare Lifesciences Fund 2 LLC, of which the reporting person is a member, in a pro rata distribution for no consideration.
- F4Immediately exercisable.