| FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF 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. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 07/03/2015 | 3. Issuer Name and Ticker or Trading Symbol Eleven Biotherapeutics, Inc. [ EBIO ] | |||||||||||||
| 4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Beneficially Owned | |||
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| 1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
| Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Stock Option (Right to Buy) | (1) | 05/17/2022 | Common Stock | 21,496 | 0.76 | D | |
| Stock Option (Right to Buy) | (2) | 02/13/2023 | Common Stock | 3,937 | 0.83 | D | |
| Stock Option (Right to Buy) | (3) | 10/30/2023 | Common Stock | 10,236 | 7.37 | D | |
| Stock Option (Right to Buy) | (4) | 02/25/2025 | Common Stock | 24,500 | 10.4 | D | |
| Stock Option (Right to Buy) | (5) | 05/20/2025 | Common Stock | 24,500 | 3.1 | D | |
| Explanation of Responses: |
| 1. This option was granted on May 17, 2012 for 31,496 shares and vests over four years, with 25% of the shares underlying the option vesting on April 23, 2013 and an additional 6.25% of the shares underlying the option vesting at the end of each three-month period thereafter. |
| 2. This option was granted on February 14, 2013 and vests over four years, with 6.25% of the shares underlying the option vesting quarterly after January 1, 2013. |
| 3. This option was granted on October 31, 2013 and vests over four years, with 6.25% of the shares underlying the option vesting quarterly after October 1, 2013. |
| 4. This option was granted on February 26, 2015 and vests over four years, with 1/16th of the shares underlying the option vesting at the end of each successive three-month period after January 1, 2015. |
| 5. This option was granted on May 21, 2015 and vests over two years, with 1/24th of the shares underlying the option vesting at the end of each successive one-month period after May 21, 2015. |
| Remarks: |
| Vice President of Finance and Business Operations Exhibit Index Exhibit 24.1 - Power of Attorney |
| /s/ John J. McCabe | 07/07/2015 | |
| ** Signature of Reporting Person | Date | |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
| * 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). | ||
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
| 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 Number. | ||
