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) 06/24/2015 | 3. Issuer Name and Ticker or Trading Symbol CATABASIS PHARMACEUTICALS INC [ CATB ] | |||||||||||||
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 | ||||
Series B Preferred Stock | (1) | (1) | Common Stock | 409 | (1) | D | |
Stock Option (right to buy) | (2) | 09/06/2021 | Common Stock | 27,237(3) | 1.93(3) | D | |
Stock Option (right to buy) | (4) | 12/17/2022 | Common Stock | 7,204(3) | 2.31(3) | D | |
Stock Option (right to buy) | (5) | 12/17/2022 | Common Stock | 10,496(3) | 2.31(3) | D | |
Stock Option (right to buy) | (6) | 12/17/2022 | Common Stock | 24,584(3) | 2.31(3) | D | |
Stock Option (right to buy) | (7) | 04/16/2023 | Common Stock | 14,305(3) | 2.31(3) | D | |
Stock Option (right to buy) | (8) | 03/18/2024 | Common Stock | 25,291(3) | 6.81(3) | D | |
Stock Option (right to buy) | (9) | 03/25/2025 | Common Stock | 4,669(3) | 11.05(3) | D |
Explanation of Responses: |
1. The Series B Preferred Stock is convertible into Common Stock on a 1-for-12.85 basis into the number of shares shown in column 3 at any time at the holder's election and automatically upon the closing of the Issuer's initial public offering without payment of further consideration. The shares have no expiration date. |
2. This option was granted on September 7, 2011 and vested as to 25% of the shares on July 14, 2012 with the remaining 75% of the shares vesting in equal monthly installments thereafter through July 14, 2015. |
3. Reflects a 1-for-12.85 reverse stock split effected on June 11, 2015. |
4. This option was granted on December 18, 2012 and vested as to 25% of the shares on December 1, 2012 with the remaining 75% of the shares vesting in equal monthly installments thereafter through December 1, 2015. |
5. This option was granted on December 18, 2012 and vested as to 25% of the shares on July 10, 2013 with the remaining 75% of the shares vesting in equal monthly installments thereafter through July 10, 2016. |
6. This option was granted on December 18, 2012 and vested as to 25% of the shares on January 1, 2014 with the remaining 75% of the shares vesting in equal monthly installments thereafter through January 1, 2017. |
7. This option was granted on April 17, 2013 and vested as to 25% of the shares on January 18, 2014 with the remaining 75% of the shares vesting in equal monthly installments thereafter through January 18, 2017. |
8. This option was granted on March 19, 2014 and vested as to 25% of the shares on January 1, 2015 with the remaining 75% of the shares vesting in equal monthly installments thereafter through January 1, 2018. |
9. This option was granted on March 26, 2015 and vests over four years with 25% of the shares vesting on March 26, 2016, and the remaining 75% of the shares vesting in equal monthly installments thereafter through March 26, 2019. |
Remarks: |
Exhibit Index: 24.1 Power of Attorney |
/s/ Joanne M. Donovan | 06/24/2015 | |
** 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. |