Statement of Changes in Beneficial Ownership (4)
13 4월 2019 - 5:17AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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. Name and Address of Reporting Person
*
Aisling Capital IV, LP
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2. Issuer Name
and
Ticker or Trading Symbol
Zosano Pharma Corp
[
ZSAN
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
__
X
__ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
888 SEVENTH AVENUE, 12TH FLOOR,
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3. Date of Earliest Transaction
(MM/DD/YYYY)
4/11/2019
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(Street)
NEW YORK, NY 10106
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person
_
X
_ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock, par value of $0.0001
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4/11/2019
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A
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428571
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A
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$3.50
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2028571
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D
(1)
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Explanation of Responses:
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(1)
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The securities are directly held by Aisling Capital IV, LP ("Aisling"), and may be deemed to be beneficially owned by Aisling Capital Partners IV, LP ("Aisling GP"), as general partner of Aisling, Aisling Capital Partners IV LLC ("Aisling Partners"), as general partner of Aisling GP, and each of the individual managing members and partners (collectively, the "Managers") of Aisling GP and Aisling Partners. The Managers of Aisling Partners are Dr. Andrew Schiff and Steve Elms.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Aisling Capital IV, LP
888 SEVENTH AVENUE, 12TH FLOOR
NEW YORK, NY 10106
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X
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Aisling Capital Partners IV, LP
888 SEVENTH AVE., 12TH FLOOR
NEW YORK, NY 10106
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X
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Aisling Capital Partners IV LLC
888 SEVENTH AVE., 12TH FLOOR
NEW YORK, NY 10106
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X
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ELMS STEVE
C/O AISLING CAPITAL MANAGEMENT LP
888 SEVENTH AVE., 12TH FLOOR
NEW YORK, NY 10106
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X
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SCHIFF ANDREW N
C/O AISLING CAPITAL MANAGEMENT LP
888 SEVENTH AVE., 12TH FLOOR
NEW YORK, NY 10106
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X
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Signatures
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AISLING CAPITAL IV, LP, by Aisling Capital Partners IV, LP, its General Partner, by Aisling Capital Partners IV LLC, its General Partner, /s/ Andrew Schiff, Managing Member
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4/12/2019
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**
Signature of Reporting Person
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Date
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AISLING CAPITAL PARTNERS IV, LP, by Aisling Capital Partners IV LLC, its General Partner, /s/ Andrew Schiff, Managing Member
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4/12/2019
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**
Signature of Reporting Person
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Date
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AISLING CAPITAL PARTNERS IV LLC, /s/ Andrew Schiff, Managing Member
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4/12/2019
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**
Signature of Reporting Person
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Date
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/s/ Steve Elms
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4/12/2019
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**
Signature of Reporting Person
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Date
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/s/ Andrew Schiff
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4/12/2019
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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