0001654954-18-000194.txt : 20180108 0001654954-18-000194.hdr.sgml : 20180108 20180108174907 ACCESSION NUMBER: 0001654954-18-000194 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20180108 FILED AS OF DATE: 20180108 DATE AS OF CHANGE: 20180108 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Anderson Raymond CENTRAL INDEX KEY: 0001362489 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55866 FILM NUMBER: 18517401 MAIL ADDRESS: STREET 1: C/O MONOPAR THERAPEUTICS INC. STREET 2: 1000 SKOKIE BLVD., SUITE 350 CITY: WILMETTE STATE: IL ZIP: 60091 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Monopar Therapeutics CENTRAL INDEX KEY: 0001645469 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 320463781 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 5 REVERE DRIVE, SUITE 200 CITY: NORTHBROOK STATE: IL ZIP: 60062 BUSINESS PHONE: 6143958936 MAIL ADDRESS: STREET 1: 5 REVERE DRIVE, SUITE 200 CITY: NORTHBROOK STATE: IL ZIP: 60062 3 1 section16.xml PRIMARY DOCUMENT X0206 3 2018-01-08 0 0001645469 Monopar Therapeutics NONE 0001362489 Anderson Raymond C/O MONOPAR THERAPEUTICS INC. 1000 SKOKIE BLVD., SUITE 350 WILMETTE IL 60091 true false false Common stock 1000 D Stock options 6.00 Common stock 21024 D Reflects the issuance of options to purchase up to 21,024 shares of common stock granted to Mr. Anderson on September 18, 2017 for his services as a director of Monopar Therapeutics. The options will vest 6/42nds at the six-month anniversary of grant date and 1/42nd per month thereafter. The options each expire on September 17, 2027. /s/ Kim R. Tsuchimoto, Attorney-in-fact 2018-01-08 EX-24 2 poaband.htm POWER OF ATTORNEY Blueprint
 
 
MONOPAR THERAPEUTICS INC.
CONFIRMING STATEMENT
REGARDING AUTHORITY TO EXECUTE SECTION 16(a) REPORTS
 
 
This Statement confirms that the undersigned, Raymond William Anderson c/o Monopar Therapeutics Inc., 1000 Skokie Blvd., Suite 350, Wilmette, IL 60091 (the “Insider”), has authorized and designated Kim R. Tsuchimoto and Chandler Robinson of Monopar Therapeutics Inc. (the “Company”), Ashley Graffeo and Robert Rupp, Esq. of Baker & Hostetler LLP, the Company’s United States legal counsel, and each of them (each of the foregoing is referred to as an “Authorized Signer”) to execute and file on the Insider’s behalf a Form ID and any and all Forms 3, 4 and 5 (including any amendments thereto) that the Insider may be required to file with the United States Securities and Exchange Commission under Section 16(a) of the Securities Exchange Act of 1934, as a result of the Insider’s ownership of, or transactions in, securities of the Company. The authority of the Authorized Signers under this Confirming Statement shall continue until the Insider is no longer required to file Forms 3, 4 and 5 with regard to the Insider’s ownership of, or transactions in, securities of the Company, unless earlier revoked in writing. The Insider acknowledges that none of the Authorized Signers is assuming any of the Insider’s responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.
 
/s/ Raymond William Anderson
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Raymond William Anderson