0001209191-17-014418.txt : 20170224 0001209191-17-014418.hdr.sgml : 20170224 20170224170716 ACCESSION NUMBER: 0001209191-17-014418 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170222 FILED AS OF DATE: 20170224 DATE AS OF CHANGE: 20170224 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Evoke Pharma Inc CENTRAL INDEX KEY: 0001403708 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 208447886 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 420 STEVENS AVENUE STREET 2: SUITE 370 CITY: SOLANA BEACH STATE: CA ZIP: 92075 BUSINESS PHONE: 858-345-1494 MAIL ADDRESS: STREET 1: 420 STEVENS AVENUE STREET 2: SUITE 370 CITY: SOLANA BEACH STATE: CA ZIP: 92075 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WIDDER KENNETH J CENTRAL INDEX KEY: 0001065168 STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835] FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36075 FILM NUMBER: 17638341 MAIL ADDRESS: STREET 1: 10070 BARNES CANYON ROAD CITY: SAN DIEGO STATE: CA ZIP: 92121 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-02-22 0 0001403708 Evoke Pharma Inc EVOK 0001065168 WIDDER KENNETH J C/O EVOKE PHARMA, INC. 420 STEVENS AVENUE, SUITE 370 SOLANA BEACH CA 92075 1 0 0 0 Common Stock 2017-02-22 4 P 0 418605 2.90 A 1472867 I Directly owned by LVP III Common Stock 2017-02-22 4 P 0 20930 2.90 A 73641 I Directly owned by Associates Common Stock 2017-02-22 4 P 0 10465 2.90 A 36821 I Directly owned by Partners Common Stock 5250 I Directly owned by LVPMC The reported securities are owned directly by each of LVPMC, LLC ("LVPMC"), LVP Life Science Ventures III, L.P. ("LVP III"), LVP III Associates, L.P. ("Associates") and LVP III Partners, L.P. ("Partners"). LVP GP III, LLC ("GP III") is the general partner of LVP III, Associates and Partners. The reporting person disclaims beneficial ownership of these shares, except to the extent of his pecuniary interest therein. /s/ Matthew J. D'Onofrio, Attorney-in-fact for Kenneth J. Widder 2017-02-24