SEC Form 3
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) 09/19/2017 | 3. Issuer Name and Ticker or Trading Symbol Acer Therapeutics Inc. [ ACER ] | |||||||||||||
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) |
Common Stock | 663,782(1) | I | See Footnote(2) |
Common Stock | 227,485(1) | I | See Footnote(3) |
Common Stock | 1,172,709(1) | I | See Footnote(4) |
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 |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. These shares were acquired pursuant to an Agreement and Plan of Merger, dated as of June 30, 2017 (the "Merger Agreement"), pursuant to which a wholly-owned subsidiary of the Issuer merged with and into Acer Therapeutics Inc. ("Acer"). Pursuant to the Merger Agreement, at the Effective Time (as defined in the Merger Agreement) of the closing of the Mergers contemplated thereby, the then outstanding shares of Acer's common stock were cancelled and were automatically converted into the right to receive 1 share of the Issuer's common stock for each share of Acer common stock then held by the Reporting Persons. |
2. The shares are directly held by TVM Life Science Ventures VI GmbH & Co. KG ("TVM VI"). Hubert Birner ("Birner"), Stefan Fischer ("Fischer"), and Helmut Schuhsler ("Schuhsler") are members of the investment committee of TVM Life Science Ventures Management VI L.P. ("TVM VI Management"), a special limited partner of TVM VI, with voting and dispositive power over the shares held by TVM VI. TVM VI Management, Birner, Schuhsler and Fischer each disclaim beneficial ownership of the shares held by TVM VI, except to the extent of any pecuniary interest therein, if any. Birner is a director of the Issuer. |
3. The shares are directly held by TVM Life Science Ventures VI L.P. ("TVM VI LP"). Birner, Schuhsler and Fischer are members of the investment committee of TVM VI Management, a special limited partner of TVM VI LP, with voting and dispositive power over the shares held by TVM VI LP. TVM VI Management, Birner, Schuhsler and Fischer each disclaim beneficial ownership of the shares held by TVM VI LP, except to the extent of any pecuniary interest therein, if any. |
4. These shares are directly held by TVM Life Science Ventures VII L.P. ("TVM VII LP"). TVM Life Science Ventures VII (GP) Ltd. ("TVM VII GP Ltd") is the general partner of TVM VII LP. Luc Marengere ("Marengere"), Mark Wanless ("Wanless"), Gary Leatt ("Leatt"), Birner, Fischer and Schuhsler are members of the investment committee of TVM VII GP Ltd, which has voting and investment power with respect to these shares. TVM VII GP Ltd, Birner, Fischer, Schuhsler, Marengere, Wanless and Leatt each disclaim any beneficial ownership of the reported securities, except to the extent of any pecuniary interest therein, if any. Marengere is a director of the Issuer. |
Remarks: |
/s/ Stefan Fischer, Director of TVM Life Science Ventures VI LLC, general partner of TVM Life Science Ventures Management VI L.P., managing limited partner of TVM Life Science Ventures VI GMBH & Co. KG | 09/27/2017 | |
/s/ Stefan Fischer, Director of TVM Life Science Ventures VI LLC, general partner of TVM Life Science Ventures Management VI L.P., managing limited partner of TVM Life Science Ventures VI L.P. | 09/27/2017 | |
/s/ Stefan Fischer, Director of TVM Life Science Ventures VII Ltd., general partner of TVM Life Science Ventures VII L.P. | 09/27/2017 | |
/s/ Stefan Fischer, Attorney in Fact for Hubert Birner | 09/27/2017 | |
/s/ Luc Marengere | 09/27/2017 | |
/s/ Stefan Fischer | 09/27/2017 | |
/s/ Stefan Fischer, Attorney in Fact for Helmut Schuhsler | 09/27/2017 | |
/s/ Mark Wanless | 09/27/2017 | |
/s/ Gary Leatt | 09/27/2017 | |
** 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. |