0001171843-17-003744.txt : 20170621
0001171843-17-003744.hdr.sgml : 20170621
20170621161726
ACCESSION NUMBER: 0001171843-17-003744
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170620
FILED AS OF DATE: 20170621
DATE AS OF CHANGE: 20170621
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: Haines Timothy
CENTRAL INDEX KEY: 0001526068
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36694
FILM NUMBER: 17923070
MAIL ADDRESS:
STREET 1: 38 JERMYN STREET
CITY: LONDON
STATE: X0
ZIP: SW1Y 6DN
4
1
formfour.xml
OWNERSHIP DOCUMENT
X0306
4
2017-06-20
0
0001359931
PROTEON THERAPEUTICS INC
PRTO
0001526068
Haines Timothy
C/O ABINGWORTH LLP
38 JERMYN STREET
LONDON
X0
SWIY 6DN
UNITED KINGDOM
1
0
1
0
Stock Option (Right to Buy)
1.30
2017-06-20
4
A
0
6666
0
A
2027-06-19
Common Stock, $0.001 par value
6666
6666
D
Tim Haines (the "Reporting Person") was granted options to purchase shares of common stock under in accordance with the Issuer's S-1 Registration Statement in consideration of his services as a director of the Issuer (the "Options"). The Options were granted on June 20, 2017 and the shares underlying the Options will vest 100% at the earlier of (i) June 20, 2018 and (ii) the Issuer's next annual meeting of stockholders.
The Reporting Person is a member of Abingworth LLP ("ALLP"). ALLP provides advisory services to Abingworth Bioventures VI, LP ("ABV VI"). Under an agreement between the Reporting Person and ALLP, the Reporting Person is deemed to hold the Options and any shares of common stock issuable upon exercise of the Options, for the benefit of ABV VI, and must exercise the Options solely upon the direction of ALLP.
ABV VI may be deemed the indirect beneficial owner of the Options, and the Reporting Person may be deemed the indirect beneficial owner of the Options through his indirect interest in ABV VI. The Reporting Person disclaims beneficial ownership of the Options except to the extent, if any, of his pecuniary interest therein. This report shall not be deemed an admission that the Reporting Person, ALLP, ABV VI or any other person is the beneficial owner of the securities reported herein for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose.
/s/ George A. Eldridge as attorney-in-fact for Timothy Haines
2017-06-21