0001104659-18-047099.txt : 20180725
0001104659-18-047099.hdr.sgml : 20180725
20180725204939
ACCESSION NUMBER: 0001104659-18-047099
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180725
FILED AS OF DATE: 20180725
DATE AS OF CHANGE: 20180725
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Medical Mutual Holdings, Inc.
CENTRAL INDEX KEY: 0001732202
STATE OF INCORPORATION: NC
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38601
FILM NUMBER: 18969779
BUSINESS ADDRESS:
STREET 1: 700 SPRING FOREST RD.
STREET 2: SUITE 400
CITY: RALEIGH
STATE: NC
ZIP: 27609
BUSINESS PHONE: 9198787614
MAIL ADDRESS:
STREET 1: 700 SPRING FOREST RD.
STREET 2: SUITE 400
CITY: RALEIGH
STATE: NC
ZIP: 27609
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Liquidia Technologies Inc
CENTRAL INDEX KEY: 0001330436
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
BUSINESS ADDRESS:
STREET 1: 419 DAVIS DRIVE
STREET 2: SUITE 100
CITY: DURHAM
STATE: NC
ZIP: 27713
BUSINESS PHONE: 919-328-4400
MAIL ADDRESS:
STREET 1: P.O. BOX 110085
CITY: RESEARCH TRIANGLE PARK
STATE: NC
ZIP: 27709
3
1
a3.xml
3
X0206
3
2018-07-25
0
0001330436
Liquidia Technologies Inc
LQDA
0001732202
Medical Mutual Holdings, Inc.
700 SPRING FOREST ROAD
SUITE 400
RALEIGH
NC
27609
0
0
1
0
Warrant to purchase Series D Preferred Stock
0.01
2017-01-12
2026-12-31
Series D Preferred Stock
27945
I
See Footnote
Series D Preferred Stock
Common Stock
160445
I
See Footnote
All shares of Series D Preferred Stock, par value $0.001 per share (the "Series D Preferred Stock"), have no expiration date and will automatically convert into the Issuer's common stock on approximately a 0.0594-for-1 basis immediately prior to the closing of the Issuer's initial public offering.
Following the automatic conversion of the Series D Preferred Stock, the Warrant to purchase Series D Preferred Stock will be exercisable into 27,945 shares of the Issuer's common stock at an exercise price of $0.01 per share.
These securities are held of record by MMIC Investment Holdings ("MMIC"). Medical Mutual Holdings, Inc. is the sole shareholder of MMIC and has exclusive voting and dispositive power over the securities.
Jason Sandner, Chief Financial Officer
2018-07-25