0000903423-15-000294.txt : 20150505 0000903423-15-000294.hdr.sgml : 20150505 20150505185356 ACCESSION NUMBER: 0000903423-15-000294 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150505 FILED AS OF DATE: 20150505 DATE AS OF CHANGE: 20150505 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HTG MOLECULAR DIAGNOSTICS, INC CENTRAL INDEX KEY: 0001169987 STANDARD INDUSTRIAL CLASSIFICATION: LABORATORY ANALYTICAL INSTRUMENTS [3826] IRS NUMBER: 860912294 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3430 E. GLOBAL LOOP CITY: TUCSON STATE: AZ ZIP: 85706 BUSINESS PHONE: 877-289-2615 MAIL ADDRESS: STREET 1: 3430 E. GLOBAL LOOP CITY: TUCSON STATE: AZ ZIP: 85706 FORMER COMPANY: FORMER CONFORMED NAME: HTG MOLECULAR DIAGNOSTICS INC DATE OF NAME CHANGE: 20110523 FORMER COMPANY: FORMER CONFORMED NAME: HIGH THROUGHPUT GENOMICS INC DATE OF NAME CHANGE: 20020326 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GLAXOSMITHKLINE PLC CENTRAL INDEX KEY: 0001131399 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] STATE OF INCORPORATION: X0 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37369 FILM NUMBER: 15834604 BUSINESS ADDRESS: STREET 1: 980 GREAT WEST ROAD CITY: BRENTFORD MIDDLESEX STATE: X0 ZIP: TW8 9GS BUSINESS PHONE: 011442080475000 MAIL ADDRESS: STREET 1: 980 GREAT WEST ROAD CITY: BRENTFORD MIDDLESEX STATE: X0 ZIP: TW8 9GS 3 1 glaxohtgf3.xml OWNERSHIP DOCUMENT X0206 3 2015-05-05 0 0001169987 HTG MOLECULAR DIAGNOSTICS, INC HTGM 0001131399 GLAXOSMITHKLINE PLC 980 GREAT WEST ROAD BRENTFORD MIDDLESEX X0 TW8 9GS UNITED KINGDOM 0 0 1 0 Series D Convertible Preferred Stock Common Stock 340314 I See Explanation of Responses Series E Convertible Preferred Stock Common Stock 141797 I See Explanation of Responses Series E Convertible Preferred Stock Warrant (Right to Buy) 0.2189 2015-01-14 2022-01-14 Series E Convertible Preferred Stock 2784593 I See Explanation of Responses The Series D Convertible Preferred Stock and Series E Convertible Preferred Stock are each convertible into Common Stock at any time at the holder's election and upon the consummation of a qualified public offering of the registrant. There is no expiration date for any series of preferred stock. Shares are held by S.R. One Limited, an indirect, wholly-owned subsidiary of GlaxoSmithKline PLC (Reporting Person). The 2,784,593 Series E Shares due upon exercise of the Warrants will convert automatically into 25,928 shares of Common Stock with an exercise price of $23.507 per share upon the closing of the Issuer's initial public offering. /s/ Victoria Whyte, Company Secretary 2015-05-05