0000899243-17-022521.txt : 20170925 0000899243-17-022521.hdr.sgml : 20170925 20170925151555 ACCESSION NUMBER: 0000899243-17-022521 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170905 FILED AS OF DATE: 20170925 DATE AS OF CHANGE: 20170925 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Anderson Rick D CENTRAL INDEX KEY: 0001445999 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35706 FILM NUMBER: 171099640 MAIL ADDRESS: STREET 1: 3600 N CAPITAL OF TEXAS HWY STREET 2: SUITE B180 CITY: AUSTIN STATE: TX ZIP: 78746 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Apollo Endosurgery, Inc. CENTRAL INDEX KEY: 0001251769 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 161630142 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1120 SOUTH CAPITAL OF TX HWY STREET 2: BUILDING 1 SUITE 300 CITY: AUSTIN STATE: TX ZIP: 78746 BUSINESS PHONE: 512-279-5100 MAIL ADDRESS: STREET 1: 1120 SOUTH CAPITAL OF TX HWY STREET 2: BUILDING 1 SUITE 300 CITY: AUSTIN STATE: TX ZIP: 78746 FORMER COMPANY: FORMER CONFORMED NAME: LPATH, INC DATE OF NAME CHANGE: 20060316 FORMER COMPANY: FORMER CONFORMED NAME: LPATH INC DATE OF NAME CHANGE: 20051202 FORMER COMPANY: FORMER CONFORMED NAME: NEIGHBORHOOD CONNECTIONS INC DATE OF NAME CHANGE: 20040323 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-09-05 0 0001251769 Apollo Endosurgery, Inc. APEN 0001445999 Anderson Rick D 3600 N CAPITAL OF TEXAS HWY, SUITE B180 AUSTIN TX 78746 1 0 1 0 Common Stock 2017-09-05 4 P 0 41000 4.04 A 1131909 I By PTV Evergreen Fund, L.P. Common Stock 2017-09-12 4 P 0 135000 3.85 A 1266909 I By PTV Evergreen Fund, L.P. Common Stock 2199186 I By PTV Sciences II, L.P. Common Stock 1347565 I By PTV IV, L.P. Common Stock 605712 I By PTV Special Opportunities I, L.P. Common Stock 45454 D These securities are owned by PTV Evergreen Fund, L.P. ("PTV EG"). PTV GP III Management, LLC ("PTV GPM") is the sole general partner of PTV GP Evergreen, L.P. ("PTV GP EG"), which is the sole general partner of PTV EG. The managers of PTV GPM are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV EG. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. These securities are owned by PTV Sciences II, L.P. ("PTV II"). Pinto TV GP Company LLC ("PTV GPC") is the sole general partner of Pinto Technology Ventures GP II, L.P. ("PTV GP II"), which is the sole general partner of PTV II. The managers of PTV GPC are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV II. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. These securities are owned by PTV IV, L.P. ("PTV IV"). PTV GP III Management, LLC ("PTV GPM") is the sole general partner of PTV GP IV, L.P. ("PTV GP IV"), which is the sole general partner of PTV IV. The managers of PTV GPM are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV IV. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. These securities are owned by PTV Special Opportunities I, L.P. ("PTV SO"). PTV GP III Management, LLC ("PTV GPM") is the sole general partner of PTV GP SO I, L.P. ("PTV GP SO"), which is the sole general partner of PTV SO. The managers of PTV GPM are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV SO. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. /s/ Rick D. Anderson 2017-09-25