0001144204-15-032128.txt : 20150518
0001144204-15-032128.hdr.sgml : 20150518
20150518180740
ACCESSION NUMBER: 0001144204-15-032128
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150518
FILED AS OF DATE: 20150518
DATE AS OF CHANGE: 20150518
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Jaguar Animal Health, Inc.
CENTRAL INDEX KEY: 0001585608
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 185 BERRY STREET, SUITE 1300
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94107
BUSINESS PHONE: 415-371-8300
MAIL ADDRESS:
STREET 1: 185 BERRY STREET, SUITE 1300
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94107
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BOCHNOWSKI JAMES J
CENTRAL INDEX KEY: 0001255743
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36714
FILM NUMBER: 15874499
MAIL ADDRESS:
STREET 1: C/O DELPHI VENTURES
STREET 2: 3000 SAND HILL ROAD STE 135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
4
1
v410859_4.xml
OWNERSHIP DOCUMENT
X0306
4
2015-05-18
0
0001585608
Jaguar Animal Health, Inc.
JAGX
0001255743
BOCHNOWSKI JAMES J
3000 SAND HILL ROAD, 1-135
MENLO PARK
CA
94025
1
0
0
0
Common Stock
2015-05-18
4
C
0
148332
A
247220
I
By Bochnowski Family Trust
Common Stock
2015-05-18
4
C
0
35714
5.60
A
282934
I
By Bochnowski Family Trust
Common Stock
2015-05-18
4
C
0
44642
5.60
A
327576
I
By Bochnowski Family Trust
Series A Preferred Stock
2015-05-18
4
C
0
224499
0
D
Common Stock
148332
0
I
By Bochnowski Family Trust
Convertible Promissory Note
5.60
2015-05-18
4
C
0
200000
0
D
Common Stock
35714
0
I
By Bochnowski Family Trust
Convertible Promissory Note
5.60
2015-05-18
4
C
0
250000
0
D
Common Stock
44642
0
I
By Bochnowski Family Trust
These securities automatically converted into Issuer's common stock on a 1.5 to 1 basis immediately prior to the consummation of Issuer's initial public offering ("IPO") and had no expiration date.
The Reporting Person is a co-trustee and beneficiary of such trust, and shares voting and investment control over such shares with his spouse.
These notes automatically converted into shares of common stock upon consummation of Issuer's IPO.
/s/ John A. Kallassy, Attorney-in-Fact
2015-05-18