09/10/2024 | Press release | Distributed by Public on 09/10/2024 15:54
FORM 4/A
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT 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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1. Title of Derivate Security | 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 | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security | 8. Price of Derivative Security | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) | 11. Nature of Indirect Beneficial Ownership |
Code | V | (A) | (D) | Date Exercisable | Expriation Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Chicago Pacific Founders UGP III, LLC 980 NORTH MICHIGAN AVENUE, SUITE 1998 CHICAGO, IL60611 |
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X |
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Chicago Pacific Founders GP III, L.P. 980 NORTH MICHIGAN AVENUE, SUITE 1998 CHICAGO, IL60611 |
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X |
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CPF III PT SPV, LLC 980 NORTH MICHIGAN AVENUE, SUITE 1998 CHICAGO, IL60611 |
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X |
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CPF III-A PT SPV, LLC 980 NORTH MICHIGAN AVENUE, CHICAGO, IL60611 |
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X |
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Chicago Pacific Founders UGP III, LLC, /s/ Michael J. Wilson, authorized signatory | 2024-09-10 |
**Signature of Reporting Person | Date |
Chicago Pacific Founders GP III, L.P., /s/ Michael J. Wilson, authorized signatory | 2024-09-10 |
**Signature of Reporting Person | Date |
CPF III PT SPV, LLC, /s/ Michael J. Wilson, authorized signatory | 2024-09-10 |
**Signature of Reporting Person | Date |
CPF III-A PT SPV, LLC, /s/ Michael J. Wilson, authorized signatory | 2024-09-10 |
**Signature of Reporting Person | Date |
(*) | If the form is filed by more than one reporting person, see Instruction 5(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) | On May 30, 2023, the reporting person filed a Form 4 which inadvertently omitted 157,416 shares and resulted in an incorrect number of shares in Column 5 of Table I. The omission effected the number of shares reported in Column 5 of Table I of each of the reporting person's subsequent filings on Form 4. |
(2) | Chicago Pacific Founders UGP, III LLC ("UGP III") is the general partner of Chicago Founders GP III, LP ("GP III"), the general partner of each of SPV III and SPV III -A. As a result, UGP III has the power to vote and dispose of the Issuer's securities held by SPV III and SPV III -A (the "Underlying Securities"). Each of UGP III and GP III disclaims beneficial ownership for the amount in excess of their pecuniary interest in the Underlying Securities. |