1. Name and Address of Reporting Person*
1 EMBARCADERO CENTER, SUITE 4050 |
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(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 09/24/2013
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3. Issuer Name and Ticker or Trading Symbol
Evoke Pharma Inc
[ EVOK ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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1. Name and Address of Reporting Person*
1 EMBARCADERO CENTER, SUITE 4050 |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
1 EMBARCADERO CENTER, SUITE 4050 |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
1 EMBARCADERO CENTER, SUITE 4050 |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
1 EMBARCADERO CENTER, SUITE 4050 |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
1 EMBARCADERO CENTER, SUITE 4050 |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
1 EMBARCADERO CENTER, SUITE 4050 |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
|
/s/ Patrick Latterell, Manager of LVPMC, LLC and Managing Member of LVP GP III, LLC, the General Partner of LVP Life Science Ventures III, L.P., LVP III Associates, L.P. and LVP III Partners, L.P. |
09/24/2013 |
|
Patrick F. Latterell, Managing Member of LVP GP III, LLC, General Partner of LVP Life Science Ventures III, L.P. |
09/24/2013 |
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Patrick F. Latterell, Managing Member of LVP GP III, LLC, General Partner of LVP III Associates, L.P. |
09/24/2013 |
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Patrick F. Latterell, Managing Member of LVP GP III, LLC, General Partner of LVP III Partners, L.P. |
09/24/2013 |
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Patrick F. Latterell |
09/24/2013 |
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Patrick F. Latterell, Manager of LVPMC, LLC |
09/24/2013 |
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** 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. |