0001209191-14-047295.txt : 20140715 0001209191-14-047295.hdr.sgml : 20140715 20140715202411 ACCESSION NUMBER: 0001209191-14-047295 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140708 FILED AS OF DATE: 20140715 DATE AS OF CHANGE: 20140715 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GLOBEIMMUNE INC CENTRAL INDEX KEY: 0001245104 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 841353925 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1450 INFINITE DRIVE CITY: LOUISVILLE STATE: CO ZIP: 80027 BUSINESS PHONE: 3036252744 MAIL ADDRESS: STREET 1: 1450 INFINITE DRIVE CITY: LOUISVILLE STATE: CO ZIP: 80027 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Torres S. Edward CENTRAL INDEX KEY: 0001552293 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-35642 FILM NUMBER: 14976860 MAIL ADDRESS: STREET 1: C/O LILLY VENTURES FUND I LLC STREET 2: 115 W. WASHINGTON ST, STE 1680 SOUTH CITY: INDIANAPOLIS STATE: IN ZIP: 46204 4/A 1 doc4a.xml FORM 4/A SUBMISSION X0306 4/A 2014-07-08 2014-07-09 0 0001245104 GLOBEIMMUNE INC GBIM 0001552293 Torres S. Edward C/O LILLY VENTURES FUND I, LLC 115 W. WASHINGTON ST, S TOWER, STE. 1680 INDIANAPOLIS IN 46204 1 0 0 0 Warrant to Purchase Common Stock (right to buy) 45.36 2014-07-08 4 C 0 1614 0.00 A 2019-07-08 Common Stock 1614 1614 I By Lilly Ventures Fund I, LLC Represents warrants to purchase shares of common stock of the Issuer following the conversion of the Series C Convertible Preferred Stock on a 1-for-31.39 share basis. The number of shares and price per share reported herein reflects such conversion. The Warrant is immediately exercisable at any time at the option of the holder. The Reporting Person is a managing director of Lilly Ventures Fund I, LLC ("Lilly Ventures") and may be deemed to be the indirect beneficial owner of the shares owned by Lilly Ventures. The Reporting Person disclaims beneficial ownership of the shares held by Lilly Ventures, except to the extent of his pecuniary interest arising therein. The Reporting Person is filing this amendment to correct the expiration date of the warrant. /s/ Matthew P. Dubofsky, Attorney-in-Fact 2014-07-15