0000925421-17-000358.txt : 20170925 0000925421-17-000358.hdr.sgml : 20170925 20170925172204 ACCESSION NUMBER: 0000925421-17-000358 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170922 FILED AS OF DATE: 20170925 DATE AS OF CHANGE: 20170925 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Krishnan Krish S CENTRAL INDEX KEY: 0001298709 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38210 FILM NUMBER: 171100485 MAIL ADDRESS: STREET 1: 1881 GROVE AVENUE CITY: RADFORD STATE: VA ZIP: 24141 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Krystal Biotech, Inc. CENTRAL INDEX KEY: 0001711279 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 810930882 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2100 WHARTON STREET STREET 2: SUITE 701 CITY: PITTSBURGH STATE: PA ZIP: 15203 BUSINESS PHONE: (412) 586-5830 MAIL ADDRESS: STREET 1: 2100 WHARTON STREET STREET 2: SUITE 701 CITY: PITTSBURGH STATE: PA ZIP: 15203 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2017-09-22 0001711279 Krystal Biotech, Inc. KRYS 0001298709 Krishnan Krish S C/O KRYSTAL BIOTECH, INC. 2100 WHARTON STREET, SUITE 701 PITTSBURGH PA 15203 1 1 1 0 President and CEO Common Stock 2017-09-22 4 P 0 100000 10.00 A 1935249 D Common Stock 2017-09-22 4 C 0 112162 A 112162 I By trust Common Stock 1935249 I By spouse Series A Convertible Preferred Stock 2017-09-22 4 C 0 112162 0 D Common Stock 112162 0 I By trust The Series A convertible preferred stock converted on a one-to-one basis into 112,162 shares of common stock upon the closing of Krystal Biotech, Inc.'s initial public offering. Directly beneficially owned by the Krishnan Family Trust. The reporting person and his spouse are each joint beneficial owners of the trust with joint voting and investment control. Directly beneficially owned by Suma M. Krishnan, the spouse of the reporting person. /s/ Katherine A. Shaia, as attorney-in-fact for Krish S. Krishnan 2017-09-25