0001209191-15-042294.txt : 20150513 0001209191-15-042294.hdr.sgml : 20150513 20150513163020 ACCESSION NUMBER: 0001209191-15-042294 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150511 FILED AS OF DATE: 20150513 DATE AS OF CHANGE: 20150513 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: JOHNSON TIM B CENTRAL INDEX KEY: 0001194674 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37369 FILM NUMBER: 15858808 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2015-05-11 0 0001169987 HTG MOLECULAR DIAGNOSTICS, INC HTGM 0001194674 JOHNSON TIM B C/O HTG MOLECULAR DIAGNOSTICS, INC. 3430 E. GLOBAL LOOP TUCSON AZ 85706 1 1 0 0 President & CEO Common Stock 2015-05-11 4 C 0 2088 A 2088 D Common Stock 2015-05-11 4 C 0 2174 A 4262 D Common Stock 2015-05-11 4 C 0 567 A 4829 D Common Stock 2015-05-11 4 C 0 98 A 4927 D Common Stock 2015-05-11 4 J 0 791 0.00 A 5718 D Series C-2 Convertible Preferred Stock 2015-05-11 4 C 0 221631 0.00 D Common Stock 2088 0 D Series D Convertible Preferred Stock 2015-05-11 4 C 0 233495 0.00 D Common Stock 2174 0 D Series E Convertible Preferred Stock 2015-05-11 4 C 0 60910 0.00 D Common Stock 567 0 D Series D Convertible Preferred Stock Warrant (right to buy) 2015-05-11 4 X 0 10544 0.00 D 2010-07-30 2020-07-29 Series D Convertible Preferred Stock 10544 0 D Series D Convertible Preferred Stock 2015-05-11 4 X 0 10544 0.00 A Common Stock 98 10544 D Series D Convertible Preferred Stock 2015-05-11 4 C 0 10544 0.00 D Common Stock 98 0 D Automatic conversion, in connection with the Issuer's initial public offering, of preferred stock into shares of common stock on a 1 for 107.39 basis, after accounting for any applicable antidilution adjustments. The shares have no expiration date. The warrant was net exercised for shares of common stock upon the closing of the Issuer's initial public offering. On April 23, 2015, the Board of Directors of the Issuer declared a dividend payable to all holders of the Series D Convertible Preferred Stock and Series E Convertible Preferred Stock of the Issuer payable in the form of shares of Common Stock of the Issuer. The dividends were issued in connection with the closing of the Issuer's initial public offering. The shares of Series D Convertible Preferred Stock have no expiration date and are convertible at any time at the election of the holder without payment of further consideration. Each share of Series D Convertible Preferred Stock will automatically convert on a 1 for 107.39 basis into shares of Common Stock upon the closing of the Issuer's initial public offering. /s/ Shaun D. McMeans, Attorney-in-Fact 2015-05-13