Alexey L Margolin Form 3 Allena Pharmaceuticals / Alexey L Margolin ownership change

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^*

Margolin Alexey L

(Last) (First) (Middle)

C/O ALLENA PHARMACEUTICALS, INC.

ONE NEWTON EXECUTIVE PARK, SUITE 202

(Street)

NEWTON MA 02459

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
11/01/2017

3. Issuer Name and Ticker or Trading Symbol
Allena Pharmaceuticals, Inc. [ ALNA ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
X	Officer (give title below)	Other (specify below)
Chief Executive Officer

5. If Amendment, Date of 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

Table I - Non-Derivative Securities Beneficially Owned
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	808,752	D

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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)	03/05/2024	Common Stock	20,834	0.75	D
Stock Option (Right to Buy)	(2)	05/15/2024	Common Stock	9,998	0.75	D
Stock Option (Right to Buy)	(3)	12/16/2024	Common Stock	215,620	1.17	D
Stock Option (Right to Buy)	(4)	03/10/2026	Common Stock	131,768	1.59	D

Explanation of Responses:

1. 25% of the shares vested on March 5, 2015 and the remaining shares vest in 36 equal monthly installments thereafter.

2. 25% of the shares vested on May 15, 2015 and the remaining shares vest in 36 equal monthly installments thereafter.

3. 25% of the shares vested on December 16, 2015 and the remaining shares vest in 36 equal monthly installments thereafter.

4. 25% of the shares vested on December 8, 2016 and the remaining shares vest in 36 equal monthly installments thereafter.

Remarks:

Exhibit 24 - Power of Attorney

	/s/ Kevin Brennan, attorney-in-fact	11/01/2017
	** 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).
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