0000899243-17-003460.txt : 20170210 0000899243-17-003460.hdr.sgml : 20170210 20170210161720 ACCESSION NUMBER: 0000899243-17-003460 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161231 FILED AS OF DATE: 20170210 DATE AS OF CHANGE: 20170210 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Corvus Pharmaceuticals, Inc. CENTRAL INDEX KEY: 0001626971 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 464670809 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 863 MITTEN ROAD STREET 2: SUITE 102 CITY: BURLINGAME STATE: CA ZIP: 94010 BUSINESS PHONE: (650) 900-4520 MAIL ADDRESS: STREET 1: 863 MITTEN ROAD STREET 2: SUITE 102 CITY: BURLINGAME STATE: CA ZIP: 94010 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MILLER RICHARD A MD CENTRAL INDEX KEY: 0001031847 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37719 FILM NUMBER: 17593511 MAIL ADDRESS: STREET 1: PHARMACYCLICS INC STREET 2: 995 E ARQUES AVE CITY: SUNNYVALE STATE: CA ZIP: 94085-4521 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2016-12-31 0 0 1 0001626971 Corvus Pharmaceuticals, Inc. CRVS 0001031847 MILLER RICHARD A MD C/O CORVUS PHARMACEUTICALS, INC. 863 MITTEN ROAD, SUITE 102 BURLINGAME CA 94010 1 1 0 0 President and CEO Common Stock, $0.0001 par value 2016-10-28 4 G 0 50000 0.00 D 1027293 I By Trust Common Stock, $0.0001 par value 2016-10-28 4 G 0 50000 0.00 D 977293 I By Trust A portion of these shares is subject to a right of repurchase held by the Issuer. These shares are held by Richard A. Miller and Sandra J. Horning, Trustees of the Miller-Horning Family Trust u/a/d January 25, 1985 (the "Miller-Horning Trust"). Dr. Miller has shared voting, investment and dispositive power over the shares held by the Miller Horning Trust. /s/ Leiv Lea, as Attorney-in-Fact for Richard A. Miller 2017-02-10