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