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