SEC Form 4
FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol Lantern Pharma Inc. [ LTRN ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Date of Earliest Transaction (Month/Day/Year) 01/14/2021 | ||||||||||||||||||||||||||
4. 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 Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | 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: |
Remarks: |
The securities which are the subject of this Form 4 are beneficially owned by Green Park & Golf Ventures, LLC ("GPG"), but directly held (in part) by Health Wildcatters Fund II, LLC ("HWF II"), GPG LPI Investment, LLC ("GPG LPI"), or Lantern 3-19 Investment, LLC ("Lantern 3-19"). Carl D. Soderstrom ("Soderstrom") and Clay M. Heighten, M.D. ("Heighten") are the managing members of GPG, which is the managing member of Health Wildcatters, LLC ("HW"), which is the managing member of HWF II. Therefore, Soderstrom, Heighten, GPG, and HW may be deemed to beneficially own the securities covered by this Form 4 which are held by HWF II. Soderstrom and Heighten are the managing members of GPG, which is the managing member GPG LPI. Therefore, Soderstrom, Heighten, and GPG may be deemed to beneficially own the securities covered by this Form 4 which are held by GPG LPI. Soderstrom, Heighten, and Gilbert G. Garcia II ("Garcia") are the managing members of Green Park & Golf Ventures II, LLC ("GPG II"), which is the managing member of Lantern 3-19. Therefore, Soderstrom, Heighten, Garcia, and GPG II may be deemed to beneficially own the securities covered by this Form 4 which are held by Lantern 3-19. GPG, GPG II, GPG LPI, Lantern 3-19, HWF II, HW, Soderstrom, Heighten, and Garcia are collectively referred to herein as the "Reporting Persons". As a result of the Issuer's public offering, which priced on January 14, 2021 (the "Public Offering Date") and is expected to close on January 20, 2021 (the "Public Offering"), of additional shares of Common Stock, par value $0.0001 (the "Common Stock"), to persons other than the Reporting Persons, each of the Reporting Persons ceased to be the beneficial owner of more than 10% of the Common Stock as of the Public Offering Date. Accordingly, this filing constitutes a Form 4 exit filing for the Reporting Persons, as the Reporting Persons are no longer subject to Section 16 of the Securities Exchange Act of 1934, as amended. |
/s/ Gilbert G. Garcia II (1) | 01/19/2021 | |
/s/ Gilbert G. Garcia II (2) | 01/19/2021 | |
/s/ Gilbert G. Garcia II (3) | 01/19/2021 | |
/s/ Gilbert G. Garcia II (4) | 01/19/2021 | |
/s/ Gilbert G. Garcia II (5) | 01/19/2021 | |
/s/ Gilbert G. Garcia II (6) | 01/19/2021 | |
/s/ Gilbert G. Garcia II | 01/19/2021 | |
/s/ Clay M. Heighten M.D. | 01/19/2021 | |
/s/ Carl D. Soderstrom | 01/19/2021 | |
** 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 4 (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. |