Kenneth Erland Johnson Form 3 XERIS PHARMACEUTICALS / KENNETH ERLAND JOHNSON 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^*

JOHNSON KENNETH ERLAND

(Last) (First) (Middle)

C/O XERIS PHARMACEUTICALS, INC.

180 N. LASALLE STREET, SUITE 1810

(Street)

CHICAGO IL 60601

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
06/20/2018

3. Issuer Name and Ticker or Trading Symbol
XERIS PHARMACEUTICALS INC [ XERS ]

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

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
See Remarks

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)

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)	02/04/2027	Common Stock	33,686	1.55	D
Stock Option (Right to Buy)	(1)	06/12/2027	Common Stock	5,280	1.55	D
Stock Option (Right to Buy)	(1)	01/31/2028	Common Stock	17,176	5.93	D
Stock Option (Right to Buy)	(1)	01/31/2028	Common Stock	22,457	5.93	D
Series C Preferred Stock	(2)	(2)	Common Stock	2,245	(2)	D

Explanation of Responses:

1. 25% of these shares shall vest on the first anniversary of the vesting commencement date, with the remainder vesting ratably over the following 36 months.

2. Each share of preferred stock is convertible on a 1.78112-for-1 basis into Common Stock at any time at the election of the Reporting Person and will automatically convert upon the closing of the Issuer's initial public offering into the number of shares of the Issuer's Common Stock shown in column 3 without payment or further consideration. The shares have no expiration date.

Remarks:

Sr. VP Clinical Development, Regulatory, Quality Assurance & Medical Affairs Exhibit 24 - Power of Attorney

	/s/ Barry Deutsch, as Attorney-in-Fact	06/20/2018
	** 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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