Peak Bio Inc.

11/18/2024 | Press release | Distributed by Public on 11/18/2024 17:56

Statement of Changes in Beneficial Ownership - Form 4

Ownership Submission
FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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(Print or Type Responses)
1. Name and Address of Reporting Person *
Patel Sandip I
2. Issuer Name and Ticker or Trading Symbol
Peak Bio, Inc. [PKBO]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
4900 HOPYARD ROAD SUITE 100
3. Date of Earliest Transaction (Month/Day/Year)
11/14/2024
(Street)
PLEASANTON, CA 94588
4. If Amendment, Date Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 11/14/2024 C(1)(2) 763,316 A (2) 763,316 D
Common Stock 11/14/2024 D(1)(3) 763,316 D (3) 0 D
Common Stock 11/14/2024 D(1)(3) 67,735 D (3) 0 I See footnote(4)
Common Stock 11/14/2024 D(1)(3) 68,891 D (3) 0 I See footnote(5)
Common Stock 11/14/2024 D(1)(3) 47,364 D (3) 0 I See footnote(6)
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. SEC 1474 (9-02)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(Month/Day/Year)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Convertible Notes (2) 11/14/2024 C(1)(2) $275,500 (2) (2) Common Stock 763,316 (2) 0 D
Stock Option (Right to Buy) $0.80 11/14/2024 D(1)(7) 400,000 (7) (7) Common Stock 400,000 $ 0 0 D

Reporting Owners

Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Patel Sandip I
4900 HOPYARD ROAD SUITE 100
PLEASANTON, CA 94588
X

Signatures

/s/ Sandip Patel 11/18/2024
**Signature of Reporting Person Date

Explanation of Responses:

* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
(1) This Form 4 reports securities transacted pursuant to the terms of the Agreement and Plan of Merger, dated as of March 4, 2024, as amended (the "Merger Agreement"), by and among the Issuer, Akari Therapeutics Plc ("Parent"), and Pegasus Merger Sub, Inc., a wholly-owned subsidiary of Parent ("Merger Sub"), pursuant to which Merger Sub merged with and into the Issuer effective as of November 14, 2024, with the Issuer surviving as a wholly owned subsidiary of Parent (the "Merger").
(2) Immediately prior to the effective time of the Merger (the "Effective Time"), the principal amount of convertible promissory notes held by the Reporting Person (together with accrued interest thereon) automatically converted into shares of common stock of the Issuer ("Peak Common Stock").
(3) At the Effective Time, each issued and outstanding share of Peak Common Stock was cancelled and converted into the right to receive 0.2935 (the "Exchange Ratio") American Depositary Shares ("ADSs") of Parent, each ADS representing a number of ordinary shares, par value $0.0001 per share (the "Ordinary Shares") of Parent.
(4) The securities are held by QuestBio LLC. The Reporting Person is managing member of the LLC and has sole dispositive power over the shares.
(5) The securities are held by Davis Island Ventures, LLC. The Reporting Person is managing member of the LLC and has sole dispositive power over the shares.
(6) The securities are held by Innovative Lifesci Investments, LLC. The Reporting Person is managing member of the LLC and has sole dispositive power over the shares.
(7) At the Effective Time, each option to purchase shares of Peak Common Stock ("Peak Option") that was outstanding immediately prior to the Effective Time and unexercised, whether or not vested, was assumed by Parent and converted into the option to purchase a number of Ordinary Shares or ADSs (any such option, an "Assumed Option") equal to the number of Peak Common Stock underlying each such Peak Option multiplied by the Exchange Ratio.
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.