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