0001209191-14-077762.txt : 20141223
0001209191-14-077762.hdr.sgml : 20141223
20141223163335
ACCESSION NUMBER: 0001209191-14-077762
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20141223
FILED AS OF DATE: 20141223
DATE AS OF CHANGE: 20141223
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: BELLICUM PHARMACEUTICALS, INC
CENTRAL INDEX KEY: 0001358403
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
BUSINESS ADDRESS:
STREET 1: 2130 WEST HOLCOMBE BOULEVARD
STREET 2: SUITE 850
CITY: HOUSTON
STATE: TX
ZIP: 77030
BUSINESS PHONE: (832) 384-1100
MAIL ADDRESS:
STREET 1: 2130 WEST HOLCOMBE BOULEVARD
STREET 2: SUITE 850
CITY: HOUSTON
STATE: TX
ZIP: 77030
FORMER COMPANY:
FORMER CONFORMED NAME: BELLICUM PHARMACEUTICALS INC
DATE OF NAME CHANGE: 20060405
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Slawin Kevin M.
CENTRAL INDEX KEY: 0001626808
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36783
FILM NUMBER: 141307309
MAIL ADDRESS:
STREET 1: C/O BELLICUM PHARMACEUTICALS, INC.
STREET 2: 2130 W. HOLCOMBE BLVD., STE. 800
CITY: HOUSTON
STATE: TX
ZIP: 77030
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2014-12-23
0
0001358403
BELLICUM PHARMACEUTICALS, INC
BLCM
0001626808
Slawin Kevin M.
C/O BELLICUM PHARMACEUTICALS, INC.
2130 W. HOLCOMBE BLVD., STE. 800
HOUSTON
TX
77030
1
1
0
0
CMO and CTO
Common Stock
2014-12-23
4
C
0
17135
A
356370
I
By the Jordana Slawin 2012 Family Trust
Common Stock
2014-12-23
4
C
0
64310
A
420680
I
By the Jordana Slawin 2012 Family Trust
Common Stock
2014-12-23
4
C
0
41801
A
462481
I
By the Jordana Slawin 2012 Family Trust
Common Stock
2014-12-23
4
C
0
16470
A
310587
I
By the Kevin Slawin 2009 Family Trust
Common Stock
2014-12-23
4
C
0
56048
A
366635
I
By the Kevin Slawin 2009 Family Trust
Common Stock
2014-12-23
4
C
0
36431
A
403066
I
By the Kevin Slawin 2009 Family Trust
Common Stock
2014-12-23
4
C
0
16904
A
21805
I
By the 2009 Slawin Family Partnership
Common Stock
2014-12-23
4
C
0
65008
A
86813
I
By the 2009 Slawin Family Partnership
Common Stock
2014-12-23
4
C
0
15666
A
102479
I
By the 2009 Slawin Family Partnership
Common Stock
2014-12-23
4
C
0
10182
A
112661
I
By the 2009 Slawin Family Partnership
Common Stock
2014-12-23
4
J
0
2537
A
115198
I
By the 2009 Slawin Family Partnership
Common Stock
2014-12-23
4
C
0
22875
A
149639
D
Common Stock
2014-12-23
4
C
0
14868
A
164507
D
Series A Convertible Preferred Stock
2014-12-23
4
C
0
29130
0.00
D
Common Stock
17135
0
I
By the Jordana Slawin 2012 Family Trust
Series A Convertible Preferred Stock
2014-12-23
4
C
0
28000
0.00
D
Common Stock
16470
0
I
By the Kevin Slawin 2009 Family Trust
Series A Convertible Preferred Stock
2014-12-23
4
C
0
28737
0.00
D
Common Stock
16904
0
I
By the 2009 Slawin Family Partnership
Series B Convertible Participating Preferred Stock
2014-12-23
4
C
0
110514
0.00
D
Common Stock
65008
0
I
By the 2009 Slawin Family Partnership
Series C Convertible Preferred Stock
2014-12-23
4
C
0
38889
0.00
D
Common Stock
22875
0
D
Series C Convertible Preferred Stock
2014-12-23
4
C
0
109328
0.00
D
Common Stock
64310
0
I
By the Jordana Slawin 2012 Family Trust
Series C Convertible Preferred Stock
2014-12-23
4
C
0
95283
0.00
D
Common Stock
56048
0
I
By the Kevin Slawin 2009 Family Trust
Series C Convertible Preferred Stock
2014-12-23
4
C
0
26633
0.00
D
Common Stock
15666
0
I
By the 2009 Slawin Family Partnership
Series C Convertible Preferred Stock
2014-12-23
4
C
0
25277
0.00
D
Common Stock
14868
0
D
Series C Convertible Preferred Stock
2014-12-23
4
C
0
71063
0.00
D
Common Stock
41801
0
I
By the Jordana Slawin 2012 Family Trust
Series C Convertible Preferred Stock
2014-12-23
4
C
0
61933
0.00
D
Common Stock
36431
0
I
By the Kevin Slawin 2009 Family Trust
Series C Convertible Preferred Stock
2014-12-23
4
C
0
17311
0.00
D
Common Stock
10182
0
I
By the 2009 Slawin Family Partnership
The Series A Convertible Preferred Stock converted into the Issuer's common stock on a 1.7-for-1 basis and had no expiration date.
The Reporting Person's spouse is trustee of the Jordana Slawin 2012 Family Trust. The Reporting Person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
The Series C Convertible Preferred Stock converted into the Issuer's common stock on a 1.7-for-1 basis and had no expiration date.
The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.
The Reporting Person is a managing partner of the 2009 Slawin Family Partnership that owns the reported securities. The Reporting Person has the dispositive power and control over the securities held by such partnership. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.
The Series B Convertible Preferred Stock converted into the Issuer's common stock on a 1.7-for-1 basis and had no expiration date.
On December 4, 2014, the Board of Directors of the Issuer declared a dividend payable to all holders of records of the Series B Convertible Participating Preferred Stock of the Issuer on December 16, 2014, payable in the form of cash or in shares of Common Stock of the Issuer, at the option of each holder. The dividends occurred in connection with the closing of the Issuer's public offering. The Reporting Person elected to receive the shares of Common Stock.
Reflects 1.7-for-1 reverse stock split which became effective on December 5, 2014.
/s/ Kevin M. Slawin, M.D.
2014-12-23