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) 10/07/2021 | 3. Issuer Name and Ticker or Trading Symbol COGNITION THERAPEUTICS INC [ CGTX ] | |||||||||||||
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 | ||||
Stock Option (right to buy) | (1) | 02/23/2031 | Common Stock | 3,865 | 1.75 | D | |
Stock Option (right to buy) | (3) | 02/27/2030 | Common Stock | 7,729 | 1.07 | D | |
Stock Option (right to buy) | (4) | 02/27/2030 | Common Stock | 3,865 | 1.07 | D | |
Stock Option (right to buy) | (2) | 09/22/2025 | Common Stock | 7,729 | 0.84 | D | |
Series B Convertible Preferred Stock | (5) | (5) | Common Stock | 1,424,014 | (5) | I | By Bios Memory SPV I, LP.(6) |
Series B Convertible Preferred Stock | (5) | (5) | Common Stock | 418,926 | (5) | I | By Bios Fund I, LP.(6) |
Series B Convertible Preferred Stock | (5) | (5) | Common Stock | 245,029 | (5) | I | By Bios Fund I, QP, LP.(6) |
Series B-1 Convertible Preferred Stock | (7) | (7) | Common Stock | 78,298 | (7) | I | By Bios Fund II, LP.(6) |
Series B-1 Convertible Preferred Stock | (7) | (7) | Common Stock | 255,765 | (7) | I | By Bios Fund II, QP, LP.(6) |
Series B-1 Convertible Preferred Stock | (7) | (7) | Common Stock | 351,844 | (7) | I | By Bios Memory SPV II, LP.(6) |
Series B-1 Convertible Preferred Stock | (7) | (7) | Common Stock | 34,238 | (7) | I | By Bios Fund II, NT, LP.(6) |
Series B-1 Convertible Preferred Stock | (7) | (7) | Common Stock | 41,620 | (7) | I | By Bios Fund III, LP.(6) |
Series B-1 Convertible Preferred Stock | (7) | (7) | Common Stock | 596,899 | (7) | I | By Bios Fund III, QP, LP.(6) |
Series B-1 Convertible Preferred Stock | (7) | (7) | Common Stock | 34,472 | (7) | I | By Bios Fund III, NT, LP.(6) |
Warrant (Right to Buy) | 03/15/2016(8) | 03/15/2023(8) | Common Stock | 33,495 | 0.03 | I | By Bios Memory SPV II, LP.(6) |
Simple Agreement for Future Equity | (9) | (9) | Common Stock | $232,933.33 | (9) | I | By Bios Fund III, LP.(6) |
Simple Agreement for Future Equity | (9) | (9) | Common Stock | $1,521,373.34 | (9) | I | By Bios Fund III, QP, LP.(6) |
Simple Agreement for Future Equity | (9) | (9) | Common Stock | $245,693.33 | (9) | I | By Bios Fund III, NT, LP.(6) |
Explanation of Responses: |
1. The option vests in four (4) equal annual installments beginning on the first anniversary of the option's grant date. The option was granted on February 23, 2021. |
2. The option is fully vested. |
3. The option vests in four (4) equal annual installments beginning on the first anniversary of the option's grant date. The option was granted on February 27, 2020. |
4. The option vests in four (4) equal annual installments beginning on the first anniversary of the option's grant date. The option was granted on February 27, 2020. |
5. The Series B Convertible Preferred Stock is convertible into shares of common stock on a one-for-one basis and has no expiration date. The number of underlying shares of common stock reported in Column 3 reflects a 1-for-3.2345 reverse stock split effected on October 1, 2021, pursuant to which each share of Series B Convertible Preferred Stock was adjusted to become convertible into 0.309166795 shares of common stock. |
6. Bios Equity Partners, LP ("Bios Equity I") is the general partner of Bios Fund I, LP and Bios Fund I QP, LP . Bios Equity Partners II, LP ("Bios Equity II") is the general partner of Bios Fund II, LP, Bios Fund II QP, LP, Bios Fund II NT, LP, and Bios Memory SPV II, LP. Bios Equity Partners III, LP ("Bios Equity III") is the general partner of Bios Fund III, LP, Bios Fund III NT, LP, and Bios Fund III QP, LP. Cavu Management, LP and Bios Capital Management, LP are the general partners of Bios Equity I, Bios Equity II, Bios Equity III and Bios Memory SPV I, LP. Bios Advisors GP, LLC, an entity that is managed and controlled by the reporting person, is the general partner of Bios Capital Management, LP. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
7. The Series B-1 Convertible Preferred Stock is convertible into shares of common stock on a one-for-one basis and has no expiration date. The number of underlying shares of common stock reported in Column 3 reflects a 1-for-3.2345 reverse stock split effected on October 1, 2021, pursuant to which each share of Series B-1 Convertible Preferred Stock was adjusted to become convertible into 0.309166795 shares of common stock. |
8. The warrant expries on the earliest of (i) March 15, 2023, (ii) upon a liquidation, dissolution or winding up of the Company, (iii) the closing of a Sale Transaction (as defined in the warrant), (iv) upon the closing of the issuer's Initial Public Offering ("IPO") or (v) upon repayment of a promissory note issued in connection with the warrant. |
9. The Simple Agreement for Future Equity is convertible into Common Stock automatically upon the closing of the issuer's IPO and has no expiration date. |
By: /s/ Lisa Ricciardi, Attorney-in-Fact | 10/07/2021 | |
** 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 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. |