0001171843-16-013526.txt : 20161206 0001171843-16-013526.hdr.sgml : 20161206 20161206163015 ACCESSION NUMBER: 0001171843-16-013526 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161202 FILED AS OF DATE: 20161206 DATE AS OF CHANGE: 20161206 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: Burke Steven Keith CENTRAL INDEX KEY: 0001619834 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36694 FILM NUMBER: 162036638 MAIL ADDRESS: STREET 1: 82 WILLIS ROAD CITY: SUDBURY STATE: MA ZIP: 01776 4 1 f4_burke120616.xml OWNERSHIP DOCUMENT X0306 4 2016-12-02 0 0001359931 PROTEON THERAPEUTICS INC PRTO 0001619834 Burke Steven Keith C/O PROTEON THERAPEUTICS 200 WEST STREET WALTHAM MA 02451 0 1 0 0 SVP and Chief Medical Officer Common Stock 2016-12-02 5 G 0 E 2500 0 D 30314 D Common Stock 2016-12-02 5 G 0 E 2500 0 D 27814 D Common Stock 2016-12-02 5 G 0 E 2500 0 D 25314 D Common Stock 2016-12-02 5 G 0 E 2500 0 A 2500 I See footnote Common Stock 2016-12-02 5 G 0 E 2500 0 A 5000 I See footnote This transaction involved a gift of securities by the reporting person to the William Conroy Burke Irrevocable Trust u/a 12/28/1998, an irrevocable trust established by the reporting person for the benefit of his son. The reporting person disclaims beneficial ownership of the shares held by his son, and this report should not be deemed an admission that the reporting person is the beneficial owner of his son's shares for purposes of Section 16 or for any other purpose. This transaction involved a gift of securities by the reporting person to the Timothy Andrew Burke Irrevocable Trust u/a 12/28/1998, an irrevocable trust established by the reporting person for the benefit of his son, who is deemed to share the reporting person's household. The reporting person disclaims beneficial ownership of the shares held by his son, and this report should not be deemed an admission that the reporting person is the beneficial owner of his son's shares for purposes of Section 16 or for any other purpose. This transaction involved a gift of securities by the reporting person to the Steven Edward Burke Irrevocable Trust u/a 11/15/2000, an irrevocable trust established by the reporting person for the benefit of his son, who is deemed to share the reporting person's household. The reporting person disclaims beneficial ownership of the shares held by his son, and this report should not be deemed an admission that the reporting person is the beneficial owner of his son's shares for purposes of Section 16 or for any other purpose. /s/ George A. Eldridge as attorney-in-fact 2016-12-06