0001209191-14-077802.txt : 20141223 0001209191-14-077802.hdr.sgml : 20141223 20141223172516 ACCESSION NUMBER: 0001209191-14-077802 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 FISCAL YEAR END: 1231 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: BROWN JAMES F CENTRAL INDEX KEY: 0001624379 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36783 FILM NUMBER: 141307786 MAIL ADDRESS: STREET 1: C/O LANDMARK INFRASTRUCTURE PARTNERS LP STREET 2: 2141 ROSECRANS AVENUE, SUITE 2100 CITY: EL SEGUNDO STATE: CA ZIP: 90245 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2014-12-23 0 0001358403 BELLICUM PHARMACEUTICALS, INC BLCM 0001624379 BROWN JAMES F C/O BELLICUM PHARMACEUTICALS, INC. 2130 W. HOLCOMBE BLVD., STE. 800 HOUSTON TX 77030 1 0 0 0 Common Stock 2014-12-23 4 C 0 679650 A 679650 I By AVG Ventures, LP Common Stock 2014-12-23 4 C 0 202372 A 882022 I By AVG Ventures, LP Common Stock 2014-12-23 4 J 0 23300 0.00 A 905322 I By AVG Ventures, LP Series B Convertible Preferred Stock 2014-12-23 4 C 0 1155405 0.00 D Common Stock 679650 0 I By AVG Ventures, LP Series C Convertible Preferred Stock 2014-12-23 4 C 0 344033 0.00 D Common Stock 202372 0 I By AVG Ventures, LP The Reporting Person is the manager of AVG Ventures GP, LLC, which is general partner of AVG Ventures, LP, which owns the reported securities. The Reporting Person shares voting and investment power with respect to shares held by AVG Ventures, LP. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. Reflects 1.7-for-1 reverse stock split which became effective on December 5, 2014. 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. 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. 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. /s/ James F. Brown 2014-12-23