0000899243-17-026031.txt : 20171113
0000899243-17-026031.hdr.sgml : 20171113
20171113162554
ACCESSION NUMBER: 0000899243-17-026031
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171113
FILED AS OF DATE: 20171113
DATE AS OF CHANGE: 20171113
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GELLERT MICHAEL E
CENTRAL INDEX KEY: 0001018650
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38276
FILM NUMBER: 171196242
MAIL ADDRESS:
STREET 1: 500 WEST MAIN STREET
CITY: LOUISVILLE
STATE: KY
ZIP: 40202
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Apellis Pharmaceuticals, Inc.
CENTRAL INDEX KEY: 0001492422
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 271537290
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 6400 WESTWIND WAY
STREET 2: SUITE A
CITY: CRESTWOOD
STATE: KY
ZIP: 40014
BUSINESS PHONE: 502-241-4114
MAIL ADDRESS:
STREET 1: 6400 WESTWIND WAY
STREET 2: SUITE A
CITY: CRESTWOOD
STATE: KY
ZIP: 40014
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-11-13
1
0001492422
Apellis Pharmaceuticals, Inc.
APLS
0001018650
GELLERT MICHAEL E
750 THIRD AVENUE, SUITE 3300
NEW YORK
NY
10017
0
0
1
0
Common Stock
2017-11-13
4
C
0
798068
A
943989
D
Series A Preferred Stock
2017-11-13
4
C
0
600000
0.00
D
Common Stock
281293
0
D
Series B Preferred Stock
2017-11-13
4
C
0
545454
0.00
D
Common Stock
255721
0
D
Series C Preferred Stock
2017-11-13
4
C
0
556830
0.00
D
Common Stock
261054
0
D
The Series A, Series B and Series C Preferred Stock converted into Common Stock on a 2.133-for-one basis upon the closing of the Issuer's initial public offering without payment of consideration. The Series A, Series B and Series C Preferred Stock were convertible at any time at the holder's election and automatically upon the closing of the Issuer's initial public offering. The shares had no expiration date.
/s/ Michael E. Gellert
2017-11-13