0001104659-14-074940.txt : 20141029 0001104659-14-074940.hdr.sgml : 20141029 20141029184224 ACCESSION NUMBER: 0001104659-14-074940 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141027 FILED AS OF DATE: 20141029 DATE AS OF CHANGE: 20141029 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PROTEON THERAPEUTICS INC CENTRAL INDEX KEY: 0001359931 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 200 WEST STREET CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: 781-890-0102 MAIL ADDRESS: STREET 1: 200 WEST STREET CITY: WALTHAM STATE: MA ZIP: 02451 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Public Joint Stock Co Pharmstandard CENTRAL INDEX KEY: 0001598754 STATE OF INCORPORATION: 1Z FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36694 FILM NUMBER: 141181204 BUSINESS ADDRESS: STREET 1: LIKHACHEVSKY DRIVE STREET 2: 5 "B" CITY: DOLGOPRUDNY STATE: 1Z ZIP: 141701 BUSINESS PHONE: 7 495 970 0032 MAIL ADDRESS: STREET 1: LIKHACHEVSKY DRIVE STREET 2: 5 "B" CITY: DOLGOPRUDNY STATE: 1Z ZIP: 141701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pharmstandard International S.A. CENTRAL INDEX KEY: 0001598762 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36694 FILM NUMBER: 141181205 BUSINESS ADDRESS: STREET 1: 65 BOULEVARD GRANDE DUCHESSE CHARLOTTE CITY: LUXEMBOURG STATE: N4 ZIP: L-1528 BUSINESS PHONE: 352 26449 557 MAIL ADDRESS: STREET 1: 65 BOULEVARD GRANDE DUCHESSE CHARLOTTE CITY: LUXEMBOURG STATE: N4 ZIP: L-1528 4 1 a4.xml 4 X0306 4 2014-10-27 0 0001359931 PROTEON THERAPEUTICS INC PRTO 0001598762 Pharmstandard International S.A. 65 BOULEVARD GRANDE DUCHESSE CHARLOTTE LUXEMBOURG N4 L-1528 LUXEMBOURG 0 0 1 0 0001598754 Public Joint Stock Co Pharmstandard LIKHACHEVSKY DRIVE 5 "B" DOLGOPRUDNY 1Z 141701 RUSSIAN FEDERATION 0 0 1 0 Common Stock 2014-10-27 4 P 0 600000 10.00 A 600000 D Common Stock 2014-10-27 4 C 0 565344 A 1165344 D Series D Convertible Preferred Stock 2014-10-27 4 C 0 8493925 0 D Common Stock 535218 0 D Option (Right to Purchase) 2014-10-27 4 J 0 6795140 D Series D Convertible Preferred Stock 428175 0 D These shares were purchased in connection with the Issuer's initial public offering of Common Stock. The shares are held by Pharmstandard International S.A. ("Pharmstandard"). Pharmstandard is a wholly owned subsidiary of Public Joint Stock Company "Pharmstandard". As the parent entity, Public Joint Stock Company "Pharmstandard" has sole voting power and investment control over the shares. Upon the closing of the Issuer's initial public offering, each share of Series D Convertible Preferred Stock automatically converted into Common Stock on a one-for-one basis (without payment of further consideration and with no expiration date) plus an additional 30,126 incremental shares as a result of an adjustment as provided for in the Company's certificate of incorporation. Reflects a 1-for-15.87 reverse stock split effected on October 6, 2014. Pharmstandard had a right to purchase shares of Series D Convertible Preferred Stock under the Series D Purchase Agreement at a price of $0.588656, which right to purchase ceased to be exercisable upon the initial filing of the Issuer's registration statement for its initial public offering, and terminated upon the completion of the Issuer's initial public offering of Common Stock. Each share of Series D Preferred Stock issuable upon exercise of the right to purchase would have been convertible into shares of the Issuer's common stock as described in footnote (3) above. By: Pharmstandard International S.A. /s/ Gerard Birchen /s/ Nicolas Gasztoniyi By: Public Joint Stock Company ''Pharmstandard'' /s/ Igor Krylov 2014-10-29