0001209191-17-035173.txt : 20170524 0001209191-17-035173.hdr.sgml : 20170524 20170524201849 ACCESSION NUMBER: 0001209191-17-035173 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170522 FILED AS OF DATE: 20170524 DATE AS OF CHANGE: 20170524 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: G1 Therapeutics, Inc. CENTRAL INDEX KEY: 0001560241 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 263648180 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 79 T.W. ALEXANDER DRIVE STREET 2: 4501 RESEARCH COMMONS, SUITE 100 CITY: RESEARCH TRIANGLE PARK STATE: NC ZIP: 27709 BUSINESS PHONE: 919-213-9835 MAIL ADDRESS: STREET 1: P. O. BOX # 110341 CITY: RESEARCH TRIANGLE PARK STATE: NC ZIP: 27709 FORMER COMPANY: FORMER CONFORMED NAME: G-Zero Therapeutics, Inc. DATE OF NAME CHANGE: 20121012 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hatteras Venture Partners IV SBIC, LP CENTRAL INDEX KEY: 0001675232 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38096 FILM NUMBER: 17868007 BUSINESS ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 BUSINESS PHONE: 919-484-0730 MAIL ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hatteras Venture Advisors IV SBIC, LLC CENTRAL INDEX KEY: 0001675236 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38096 FILM NUMBER: 17868008 BUSINESS ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 BUSINESS PHONE: 919-484-0730 MAIL ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Thorp Clay CENTRAL INDEX KEY: 0001592380 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38096 FILM NUMBER: 17868009 MAIL ADDRESS: STREET 1: C/O HATTERAS VENTURE PARTNERS III, LP STREET 2: 280 S. MANGUM ST., SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Reed Douglas MD CENTRAL INDEX KEY: 0001291262 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38096 FILM NUMBER: 17868010 MAIL ADDRESS: STREET 1: C/O VECTOR FUND MANAGEMENT STREET 2: 1751 LAKE COOK ROAD, SUITE 350 CITY: DEERFIELD STATE: IL ZIP: 60015 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: INGRAM ROBERT ALEXANDER CENTRAL INDEX KEY: 0001219890 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38096 FILM NUMBER: 17868012 MAIL ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 FORMER NAME: FORMER CONFORMED NAME: INGRAM ROBERT A DATE OF NAME CHANGE: 20030222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Crumpler John CENTRAL INDEX KEY: 0001674107 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38096 FILM NUMBER: 17868013 MAIL ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEE KENNETH B JR CENTRAL INDEX KEY: 0001208570 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38096 FILM NUMBER: 17868011 MAIL ADDRESS: STREET 1: 7100 WEST CREDIT AVENUE, SUITE 101 STREET 2: C/O ARALEZ PHARMACEUTICALS INC. CITY: MISSISSAUGA STATE: A6 ZIP: L5N 0E4 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-05-22 0 0001560241 G1 Therapeutics, Inc. GTHX 0001592380 Thorp Clay C/O G1 THERAPEUTICS, INC. 79 T.W. ALEXANDER DRIVE RESEARCH TRIANGLE PARK NC 27709 0 0 1 0 0001675236 Hatteras Venture Advisors IV SBIC, LLC C/O G1 THERAPEUTICS, INC. 79 T.W. ALEXANDER DRIVE RESEARCH TRIANGLE PARK NC 27709 0 0 1 0 0001675232 Hatteras Venture Partners IV SBIC, LP C/O G1 THERAPEUTICS, INC. 79 T.W. ALEXANDER DRIVE RESEARCH TRIANGLE PARK NC 27709 0 0 1 0 0001674107 Crumpler John C/O G1 THERAPEUTICS, INC. 79 T.W. ALEXANDER DRIVE RESEARCH TRIANGLE PARK NC 27709 0 0 1 0 0001219890 INGRAM ROBERT ALEXANDER C/O G1 THERAPEUTICS, INC. 79 T.W. ALEXANDER DRIVE RESEARCH TRIANGLE PARK NC 27709 0 0 1 0 0001208570 LEE KENNETH B JR C/O G1 THERAPEUTICS, INC. 79 T.W. ALEXANDER DRIVE RESEARCH TRIANGLE PARK NC 27709 0 0 1 0 0001291262 Reed Douglas MD C/O G1 THERAPEUTICS, INC. 79 T.W. ALEXANDER DRIVE RESEARCH TRIANGLE PARK NC 27709 0 0 1 0 Common Stock 2017-05-22 4 C 0 3728464 A 3728464 I By Hatteras Venture Partners IV SBIC, LP Common Stock 2017-05-22 4 C 0 212419 A 212419 I By Hatteras NC Fund, LP Common Stock 2017-05-22 4 C 0 99513 A 99513 I By L2 Ventures, LLC Common Stock 2017-05-22 4 P 0 133333 15.00 A 3861797 I By Hatteras Venture Partners IV SBIC, LP Series 1 Preferred Stock 2017-05-22 4 C 0 1318681 D Common Stock 439560 0 I See Footnote Series A Preferred Stock 2017-05-22 4 C 0 6568527 D Common Stock 2189508 0 I See Footnote Series B Preferred Stock 2017-05-22 4 C 0 2584959 D Common Stock 861651 0 I See Footnote Series C Preferred Stock 2017-05-22 4 C 0 1009693 D Common Stock 336563 0 I See Footnote The Preferred Stock automatically converted into Common Stock upon the closing of the Issuer's initial public offering pursuant to the Issuer's Fifth Restated Certificate of Incorporation, as amended, based on the conversion rate in effect at the time of conversion. The Series 1 Preferred Stock, Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock converted to Common Stock on a 1-for-3 basis. The reportable securities are owned directly by Hatteras Venture Partners IV SBIC, LP ("HVP IV"). Hatteras Venture Advisors IV SBIC, LLC ("HVA IV SBIC") is the general partner of HVP IV. The securities directly held by HVP IV are indirectly held by the individual managing members of HVA IV SBIC (each, a "GP Managing Member" and collectively, the "GP Managing Members"). The GP Managing Members are John Crumpler, Clay Thorp, Ken Lee, Douglas Reed and Robert Ingram. The GP Managing Members may share voting and dispositive power over the securities directly held by HVP IV. Each GP Managing Member disclaims beneficial ownership of these securities and this report is not an admission that any GP Managing Member is a beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of his pecuniary interest therein. The reportable securities are owned directly by Hatteras NC Fund, LP ("Hatteras NC"). Hatteras Venture Advisors IV, LLC ("HVA IV") is the general partner of Hatteras NC Fund, LP. The securities directly held by Hatteras NC are indirectly held by the individual managing members of HVA IV (each, a "HVA IV Managing Member" and collectively, the "HVA IV Managing Members"). The HVA IV Managing Members are John Crumpler, Clay Thorp, Ken Lee, Douglas Reed and Robert Ingram. The HVA IV Managing Members may share voting and dispositive power over the securities directly held by HVP IV. Each HVA IV Managing Member disclaims beneficial ownership of these securities and this report is not an admission that any HVA IV Managing Member is a beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of his pecuniary interest therein. The reportable securities are owned directly by L2 Ventures, LLC ("L2 Ventures"). Hatteras Venture Advisors V, LLC ("HVA V") is the general partner of L2 Ventures. The securities directly held by L2 Ventures are indirectly held by the individual managing members of HVA V (each, a "L2 Managing Member" and collectively, the "L2 Managing Members"). The L2 Managing Members are John Crumpler, Clay Thorp, Christy Shaffer, Douglas Reed and Robert Ingram. The L2 Managing Members may share voting and dispositive power over the securities directly held by HVA V. Each L2 Managing Member disclaims beneficial ownership of these securities and this report is not an admission that any L2 Managing Member is a beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of his pecuniary interest therein. Reflects shares Hatteras Venture Partners IV SBIC, LP purchased in the initial public offering at the initial public offering price of $15.00 per share. The Series 1 Preferred Stock, Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock automatically converted into shares of Common Stock upon consummation of the Issuer's initial public offering and had no expiration date. Includes shares of Series A Preferred Stock convertible into 1,990,276 shares of the Issuer's common stock held by HVP IV and shares of Series A Preferred Stock convertible into 199,232 shares of the Issuer's common stock held by Hatteras NC. Includes shares of Series B Preferred Stock convertible into 804,208 shares of the Issuer's common stock held by HVP IV and shares of Series B Preferred Stock convertible into 57,443 shares of the Issuer's common stock held by L2 Ventures, LLC. Includes shares of Series C Preferred Stock convertible into 294,493 shares of the Issuer's common stock held by HVP IV and shares of Series C Preferred Stock convertible into 42,070 shares of the Issuer's common stock held by L2 Ventures, LLC. /s/ Caroline G. Gammill, attorney-in-fact 2017-05-24